GU tract conditions

Question 1

What is testicular torsion?

Answer 1

the testis is abnormally twisted on its spermatic cord, thus compromising arterial supply and venous drainage of the testis, leading to testicular ischemia

Question 2

What are the clinical findings of testicular torsion?

Answer 2

Sudden onset of unilateral pain and scrotal swelling are present. Testis is painful to palpation: testicle and scrotum are edematous. There is no relief with elevation of the testicle. (negative phrens signs)

Question 3

How do we diagnose testicular torsion?

Answer 3

clinical diagnosis

Question 4

How do we treat testicular torsion?

Answer 4

mild analgesics may be administered once the diagnosis is made. This is a SURGICAL EMERGENCY. Manual detorsion required. Successful or not surgery will still have to be preformed and then preformed again electively on the other testicle.

Question 5

What is a varicocele?

Answer 5

the formation of a venous varicosity within the spermatic vein (pampiniform plexus)

Question 6

Which spermatic cord is most likely to develop a varicocele?

Answer 6

The left because the vein is longer than the right and joins the left renal vein at a right angle.

Question 7

What are the clinical features of a varicocele?

Answer 7

A chronic, non-tender mass that does not transluminate is seen. The lesion has the consistency of a bag of worms, increased with the valsalva and decreases with elevation of the scrotum or supine positition.

Question 8

What is the diagnostic method of choice for a varicocele?

Answer 8

doppler sonography

Question 9

How is a varicocele treated?

Answer 9

surgical repair (left spermatic vein ligation) can be preformed if the varicocele is painful or if it appears to be a cause of infertility.

Question 10

What is a spermatocele?

Answer 10

A typically painless cystic mass containing sperm that lies superior and posterior and are distinct from the testes. Some may stimulate a solid tumor.

Question 11

What are the clinical findings for a spermatocele?

Answer 11

a palpable, round, firm, cystic mass with distinct borders, free floating above the testicle which transluminates. The mass may be tender.

Question 12

What is the diagnostic method of choice for a spermatocele?

Answer 12

Scrotal US

Question 13

How do we treat a spermatocele?

Answer 13

no treatment needed. Large spermatoceles can be surgically removed or sclerosed

Question 14

What is a hydrocele?

Answer 14

A mass of the fluid filled congenital remnants of the tunica vaginalis, usually resulting from a patent processus vaginalis.

Question 15

What are the clinical findings of a hydrocele?

Answer 15

A soft nontender fullness of the hemiscrotum that transluminates. The mass may wax and wane in size; an indirect hernia may be concurrently present.

Question 16

What is the treatment for a hydrocele?

Answer 16

Elective repair is clinically indicated

Question 17

What is benign prostatic hyperplasia?

Answer 17

The most common benign tumor in men and its incidence is age related.

Question 18

What are the signs and symptoms for benign prostatic hyperplasia?

Answer 18

hesitancy, decreased force, straining, dribbling, urgency, frequency and nocturia

Question 19

What needs to be included in the physcial exam in a patient with benign prostatic hyperplasia?

Answer 19

A physcial exam, DRE and focused neuro exam should be preformed in all patients. Examination of the lower abdomen should be preformed to assess for a distended bladder.

Question 20

How do we treat benign prostatic hyperplasia?

Answer 20

patients with mild symptoms (AUA scores 0-7) should be manage with watchful waiting only.