Disorders of Testes, Scrotum

Question 1

Direct hernia

Answer 1

Through external ring. Touches side of finger

Question 2

-Often seen at birth or result of injury/inflamm. -Rarely symptomatic. Soft, fluid filled cystic mass anterior to testicle and epidiymitis -Transillumination, UA, US -Tx undelrying cause

Answer 2

Hydrocele

Question 2

Cyst of epididymis Usually painless and asymptomatic Transillumination, US, UA Usually does not require Tx

Answer 2

Spermatocele

Question 3

-Abnormal dilation of spermatic cord veins due to faulty valvular venous return. -Painless, Bag of worms

Answer 3

Variocele

Question 4

Semen redirected into bladder (or just no ejaculation) due to bladder sphincter not closing (or hypertrophied/weakened prostate) “Milky” urine UA Tx of underlying cause

Answer 4

Retrograde ejaculation

Question 5

Indirect hernia

Answer 5

Through internal ring. Touches tip of finger.

Question 6

-Painful enlargement of epidymis, better with scrotal elevation -Can be STI related or not -Painful, swollen scrotum; fever; voiding symptoms; discharge -CBC, UA/STI -ABX

Answer 6

Epidiymitis

Question 7

Torion of testicular appendages Similar to torsion symptoms but w/o n/v Pain to upper pole of teste or epidermis Blue spot sign=pathonomonic Usually self limiting

Answer 7

Torsion of the appendices of the testis

Question 9

-Isolated inflammation of testicle -Often seen w/ systemic infix (mumps or other virals) -Swollen erythematous teste, painful -Rule out STI, UA -Tx underlying

Answer 9

Orchitis

Question 10

Spermatic cord twists, cutting off blood to supply #ischemia -Existing abnormal fixation of test=inability to twist (often w/o preceding cause) -Young men, severe unilateral, acute teste pain, n/v, teste often high than other -Cremasteric reflex often absent -Detorsion

Answer 10

Testicular Torsion