Disorders of the scrotum and testes

Question 1

Differentiate between undescended testes from retractable testes

Answer 1

Retract into the inguinal canal with cremasteric muscle reflex
Are usually palpable at birth
Careful palpation in warm room can brings them down
Usually assume a scrotal position during puberty**
No complications that are associated with cryptorchidism

Question 2

Hydrocele

Answer 2

Excess fluid collects between the layers of the tunica vaginalis usually peritoneal fluid due to a weakness in the patent processus vaginalis**
Due to a primary congenital defect or secondary condition

Question 3

Hydrocele develops in a young man without apparent cause:

Answer 3

It should be considered cancer until proven otherwise

Careful evaluation is needed to exclude cancer or infection

Question 4

In an adult male, hydrocele is a relatively benign condition:

Answer 4

Is often asymptomatic
Feeling of heaviness in the scrotum
Pain in the lower back

Question 5

Spermatocele

Answer 5

Painless, sperm-containing cyst that forms on the epididymis
Located above and posterior to the testes
Attached to the epididymis
Separate from the testes
Freely movable and should transilluminate
Rarely cause problems

Question 6

Varicocele

Answer 6

Varicosities of the pampiniform plexus:
More common on left side because inserts to left renal vein.
If on right side think a tumor pressing on IVC

Question 7

Blue Dot Sign

Answer 7

Torsion of Appendix Tested

Question 8

Primary hypogonadism

Answer 8

Failure of testes to respond to FSH and LH
Testosterone is low to inhibit production of FSH and LH
Most common cause is Klinefelters Syndrome

Question 9

Secondary hypogonadism

Answer 9

Failure of hypothalamus to produce gonadotropin-releasing hormone (GnRH) or pituitary gland to produce enough FSH and LH