Benign testicular conditions

Question 1

What is acute epididymo-orchitis?

Answer 1

Acute inflammation of epididymis, often involving the testes

Question 2

What causes acute epididymo-orchitis?

Answer 2

Usually bacterial infection

Amiodarone

Question 3

What bacteria normally cause acute epididymo-orchitis?

Answer 3

<35= chlamydia, gonorrhoea
>35= E. coli

Question 4

What are the common triggers of acute epididymo-orchitis?

Answer 4

Urological instrumentation

Associated with mumps

Question 5

What is the presentation of acute epididymo-orchitis?

Answer 5

Tendernesss and pain of epididymis, eased by elevating testes
Swelling
History of dysuria and discharge
Leucocytes in urine

Question 6

What is the management of acute epididymo-orchitis?

Answer 6

Antibitoics

Stop amiodarone

Question 7

Who are epididymal cysts usually seen in?

Answer 7

> 40s

Question 8

What is the presentation of epididymal cysts?

Answer 8

Swelling separate from testes, usually posterior

Question 9

What investigations ar done for epididymal cysts?

Answer 9

US

Question 10

What is the management of epididymal cysts?

Answer 10

Conservative

Large/symptomatic= surgery

Question 11

What is testicular torsion?

Answer 11

Twist of spermatic cord causing testicular ischaemia and necrosis

Question 12

Wh is testicular torsion seen in?

Answer 12

10-30yo

Peak at 13-15

Question 13

What is the presentation of testicular torsion?

Answer 13

Sudden onset, severe pain not eased by elevation
Tenderness of entire testis
Loss of cremastric reflex
History of trauma

Question 14

What is the management of testicular torsion?

Answer 14

Emergency surgical exploration

If torted testis, both testis fixed

Question 15

What is the presentation of torsion of testicular appendage?

Answer 15

Pain in one testicle
Swelling and redness
Present cremaster reflex
Blue dot sign
More gradual onset

Question 16

What is the management of torsion of testicular appendage?

Answer 16

Analgesia and rest

Question 17

What is hydrocele?

Answer 17

Accumulation of fluid within tunica vaginalis

Question 18

What are the 2 types of hydrocele?

Answer 18

Communicating

Non-communicating

Question 19

What is the presentation of a hydrocele?

Answer 19

Mass in tesis- transilluminates, usually possible to get above
Not easily distinguishable from testis

Question 20

What investigations are done for hydrocele?

Answer 20

Transillumination

US in young to exclude cancer

Question 21

What is the management of hydrocele?

Answer 21

Children= conservative until age 5
Adults= surgery if symptomatic/problematic

Question 22

What i a varicocele?

Answer 22

Abnorml enlargement of testicular veins

Question 23

Where are varicoceles more often seen?

Answer 23

80% on left side due to drainage into renal vein

Question 24

What is varicocele associated with?

Answer 24

Presenting feature of renal cell carcinoma

Associated with infertility

Question 25

What is the presentation of varicocele?

Answer 25

Often asymptomatic
“bag of worms”
Subfertility
Pain/tenderness

Question 26

What investigations are done for varicocele?

Answer 26

US with doppler

Question 27

What is the management of varicocele?

Answer 27

Usually conservative

Surgery if painful

Question 28

What is cryptorchidism?

Answer 28

Undescended testis by 3 months

Question 29

What are the types of cryptorchidism?

Answer 29

True
Retractile
Ectopic
Ascending

Question 30

what is the management of cryptorchidism?

Answer 30

Orchidopexy at 6-18 months

Teenagers- orchidectomy due to risk of cancer

Question 31

What are the complications of cryptorchidism?

Answer 31

40x increased risk of cancer

Reduced fertility