Benign testicular conditions Flashcards
What is acute epididymo-orchitis?
Acute inflammation of epididymis, often involving the testes
What causes acute epididymo-orchitis?
Usually bacterial infection
Amiodarone
What bacteria normally cause acute epididymo-orchitis?
<35= chlamydia, gonorrhoea >35= E. coli
What are the common triggers of acute epididymo-orchitis?
Urological instrumentation
Associated with mumps
What is the presentation of acute epididymo-orchitis?
Tendernesss and pain of epididymis, eased by elevating testes
Swelling
History of dysuria and discharge
Leucocytes in urine
What is the management of acute epididymo-orchitis?
Antibitoics
Stop amiodarone
Who are epididymal cysts usually seen in?
> 40s
What is the presentation of epididymal cysts?
Swelling separate from testes, usually posterior
What investigations ar done for epididymal cysts?
US
What is the management of epididymal cysts?
Conservative
Large/symptomatic= surgery
What is testicular torsion?
Twist of spermatic cord causing testicular ischaemia and necrosis
Wh is testicular torsion seen in?
10-30yo
Peak at 13-15
What is the presentation of testicular torsion?
Sudden onset, severe pain not eased by elevation
Tenderness of entire testis
Loss of cremastric reflex
History of trauma
What is the management of testicular torsion?
Emergency surgical exploration
If torted testis, both testis fixed
What is the presentation of torsion of testicular appendage?
Pain in one testicle Swelling and redness Present cremaster reflex Blue dot sign More gradual onset
What is the management of torsion of testicular appendage?
Analgesia and rest
What is hydrocele?
Accumulation of fluid within tunica vaginalis
What are the 2 types of hydrocele?
Communicating
Non-communicating
What is the presentation of a hydrocele?
Mass in tesis- transilluminates, usually possible to get above
Not easily distinguishable from testis
What investigations are done for hydrocele?
Transillumination
US in young to exclude cancer
What is the management of hydrocele?
Children= conservative until age 5 Adults= surgery if symptomatic/problematic
What i a varicocele?
Abnorml enlargement of testicular veins
Where are varicoceles more often seen?
80% on left side due to drainage into renal vein
What is varicocele associated with?
Presenting feature of renal cell carcinoma
Associated with infertility
What is the presentation of varicocele?
Often asymptomatic
“bag of worms”
Subfertility
Pain/tenderness
What investigations are done for varicocele?
US with doppler
What is the management of varicocele?
Usually conservative
Surgery if painful
What is cryptorchidism?
Undescended testis by 3 months
What are the types of cryptorchidism?
True
Retractile
Ectopic
Ascending
what is the management of cryptorchidism?
Orchidopexy at 6-18 months
Teenagers- orchidectomy due to risk of cancer
What are the complications of cryptorchidism?
40x increased risk of cancer
Reduced fertility
