Disorder of testies, scrotum & spermatic cord

Question 1

Epididymitis- Eti

Answer 1

• STD, men under 40- chlamydia & gonorrhea

- Non-STD older men, gram - rods

Question 2

Epididymitis- Sx

Answer 2

• Irritative voiding sx
• Fever & scrotal swelling
• Pain radiating along spermatic cord

Question 3

Epididymitis- Dx

Answer 3

Urinalysis

Question 4

Epididymitis- Tx

Answer 4

Abx

- Bed rest with scrotal elevation

Question 5

Varicocele- Eti

Answer 5

Most common cause of sub fertility in men

- 15% men, 40% with infertility

Question 6

Direct inguinal hernia- Eti

Answer 6

Hernia through posterior wall of canal

• Weakness at Hesselbach triangle
• Acquired

Question 7

Direct inguinal hernia- Sx

Answer 7

• Rarely pain

- Felt on side of finger in palpation

Question 8

Direct inguinal hernia- Tx

Answer 8

Surgical repair

Question 9

Indirect inguinal hernia- Eti

Answer 9

• Occurs in males & females

- Descened to the scrotal sac

Question 10

Indirect inguinal hernia- Sx

Answer 10

• Pain or bulge over inguinal ligament

- Touches tip of finger

Question 11

Indirect inguinal hernia- Tx

Answer 11

Surgical repair

Question 12

Testicular torsion- Eti

Answer 12

• Prepubescent
• Twisting of spermatic cord, cut off blood supple
• Rare > 30
• Common during sleep

Question 13

Testicular torsion- Sx

Answer 13

• Painful, firm testicle riding high
• Absence of cremasteric reflex
• Severe pain in lower abdomen, inguinal canal

Question 14

Testicular torsion- Tx

Answer 14

• Detorsion

Question 15

Torsion of appendices of testis- Eti

Answer 15

• Spontaneous infarction of vestigial appendage in young boys

Question 16

Torsion of appendices of testis- Sx

Answer 16

• Blue dot sign- small blue lump on superior pole of testis
• Pain
• Non-tender testes

Question 17

Torsion of appendices of testis- Dx

Answer 17

Scrotal US

Question 18

Torsion of appendices of testis- Tx

Answer 18

Pain mgmt

Question 19

Retrograde ejaculation- Eti

Answer 19

• Deficient bladder neck closure or urethral stricture

- DM, meds, surgery

Question 20

Retrograde ejaculation- Sx

Answer 20

• Cloudy urine after orgasm
• Male infertility
• Low volume or dry ejaculate

Question 21

Retrograde ejaculation- Tx

Answer 21

• Pseudoephedrine

- Dextroamphtamine

Question 22

Orchitis- Eti

Answer 22

• Mumps or viral infection

- May be due to recurrent epididymitis

Question 23

Orchitis- Sx

Answer 23

• Swollen, painful testicle
• Spares epididymus
• Constitutional sx
• Erythema & edema on scrotum

Question 24

Orchitis- Dx

Answer 24

• R/O testicular torsion with US

- STI screening

Question 25

Orchitis- Tx

Answer 25

• If viral, tx symptoms
• Abx
• Scrotal elevation

Question 26

Hydrocele- Eti

Answer 26

• Associated with cancer
• Fluid between tunica vaginalis
• Common in newborns or older with injury/ inflammation
• Slow progression

Question 27

Hydrocele- Sx

Answer 27

• Soft, pear shaped mass
• Painless swelling of testicles
• Transillumiates
• Anterior to testes

Question 28

Hydrocele- Tx

Answer 28

Surgical drainage

Question 29

Varicocele- Sx

Answer 29

• Bag of worms
• Pain with prolonged standing
• Engorgement of internal spermatic vein
• Commonly on left side

Question 30

varicocele- Dx

Answer 30

Ultrasound

Valsalva manuver

Question 31

Varicocele- Tx

Answer 31

Varicoectomy, embolization

Question 32

Spermatocele- Eti

Answer 32

• Cyst of sperm on top of epididymal head
• Benign
• Up to 10 cm

Question 33

Spermatocele- Sx

Answer 33

• Painless cystic growth
• Outside contour of testicle
• Soft & fluctuant
• Filled with sperm and milky fluid
• Scrotal heaviness

Question 34

Spermatocele- Tx

Answer 34

None

- Aspiration and excision if painful