Inguinoscrotal Conditions Flashcards
Q: What is testicular torsion?
A: Testicular torsion is the twisting of the spermatic cord around a vertical axis, leading to venous obstruction, testicular swelling, and potential infarction. It is a surgical emergency and requires prompt intervention within 4-6 hours to prevent testicular loss.
Q: What are the clinical features of testicular torsion?
A:
- Sudden onset of scrotal pain, often severe.
- Swelling of the scrotum and a high-riding testis.
- Absence of the cremasteric reflex and negative Prehn’s sign.
- The affected testis may be firm, tender, and have a horizontal lie.
Q: What is the treatment for testicular torsion?
A: Treatment involves immediate surgical detorsion and bilateral orchiopexy (fixation of both testes) to prevent recurrence. Manual detorsion may be attempted but should always be followed by surgery.
Q: What is an inguinal hernia?
A: An inguinal hernia is the protrusion of abdominal contents through the inguinal canal into the scrotum. It can be classified as direct (through the abdominal wall) or indirect (through a patent processus vaginalis).
Q: How is an inguinal hernia classified?
A:
- Indirect hernia: Enters through the internal inguinal ring and follows the path of the spermatic cord into the scrotum.
- Direct hernia: Protrudes through a weakness in the abdominal wall in Hesselbach’s triangle.
Q: What are the clinical features of inguinal hernia?
A:
- A scrotal mass that may increase with straining or standing.
- Discomfort or pain in the groin, especially with physical activity.
- In cases of incarceration or strangulation, there may be acute pain and bowel obstruction.
Q: What is the treatment for an inguinal hernia?
A: The treatment is surgical, either by open or laparoscopic hernia repair. Emergent surgery is required for incarcerated or strangulated hernias.
Q: What is a hydrocele?
A: A hydrocele is an accumulation of fluid between the layers of the tunica vaginalis surrounding the testis. It may be congenital or acquired and presents as painless scrotal swelling.
Q: How are hydroceles classified?
A:
1. Congenital hydrocele: Results from the failure of the processus vaginalis to close, allowing peritoneal fluid to accumulate.
2. Acquired hydrocele: Can occur due to trauma, infection, tumor, or systemic disease.
Q: What is the clinical presentation of a hydrocele?
A:
- Painless swelling of the scrotum.
- A transilluminable scrotal mass (light passes through the fluid).
- The size of the hydrocele may fluctuate with activity or time of day.
Q: How is a hydrocele treated?
A: In infants, observation is recommended as many congenital hydroceles resolve spontaneously. In adults, surgical repair (hydrocelectomy) is performed for discomfort or when the hydrocele obscures testicular examination.
Q: What is a spermatocele?
A: A spermatocele is an epididymal cyst that contains spermatozoa. It presents as a painless, cystic mass located above the testis.
Q: What are the clinical features of a spermatocele?
A:
- A painless, cystic mass that lies above the testis.
- The mass is often small and transilluminates.
- It is usually found incidentally on physical examination.
Q: How is a spermatocele treated?
A: Treatment is usually not required unless the spermatocele causes discomfort or is large. In such cases, surgical removal (spermatocelectomy) is performed.
Q: What is a varicocele?
A: A varicocele is an abnormal dilation and tortuosity of the veins in the pampiniform plexus of the scrotum, more commonly on the left side.
