Corrections - Renal/Urology Flashcards
Management of adult patients with a hydrocele?
Require an urgent US to exclude underlying causes such as a tumour.
Investigation for diagnosis of a varicocele?
US with Doppler studies
Management of intermittent testicular torsion?
Consider prophylactic fixing with emergency surgery (due to high risk).
What is an epididymal cyst?
The most common cause of scrotal swelling in 1ary care.
Causes a swelling separate from the body of the testicle & found posterior to the testicle.
What 3 conditions are epididymal cysts associated with?
1) Polycystic kidney disease
2) CF
3) von Hippel-Lindau syndrome
What type of cancer are 95% of testicular cancers?
Germ cell tumours
What can germ cell testicular cancers be divided into?
Seminomas
Non-seminomas e.g. teratoma and choriocarcinoma
What do non-germ cell testicular tumours include?
Leydig cell tumours & sarcomas
What are some risk factors for testicular cancer?
- infertility (increases risk by a factor of 3)
- cryptorchidism
- FH
- Klinefelter’s syndrome
- mumps orchitis
What is the most common presenting feature of testicular cancer?
A painless lump
Do seminomas or non-seminomas have a better prognosis?
Seminomas:
- tender to be less agressive
- more sensitive to radiation & chemo
Features of testicular cancer?
- painless lump
- hydrocele
- gynaecomastia
What causes gynaecomastia in testicular cancer?
Due to an increased oestrogen:androgen ratio.
What do germ cell tumours secrete?
hCG –> this causes Leydig cells to increase production of oestrogen and testosterone (but risk in oestrogen is relatively greater than testosterone).
1st line investigation in testicular cancer?
US
