Lumps and Bumps: Groin and Testicular Lumps Flashcards
Causes of Testicular Pain
Causes of Testicular Pain by Age Group
Prepubertal: Mumps Orchitis, Idiopathic Scrotal Oedema, Testicular Tortion.
Adolescent (10-21): Testicular Tortion (most likey), epididymo-orchitis, tortion of the Hydatid or Morgagni (7-14 years)
Adult (>21): Epididymo-orchitis (most likely), Testicular Tortion
All Age Groups: Trauma, rarely testicular tumours can present with pain.
Ix for Testicular Pain
If suspect testicular torsion on clinical grounds {acute onset, pubescent, episodes of previous testicular pain, exquistetly tender, swollen testicle ?Bell Clapper Deformity (where testical is lying horizontally)} then no investigations required and the patient needs to be take to theatre within 6 hours to avoid irreversible ischaemia and testicular infarction.
Can do a Doppler to assess blood flow into the testicle which would be reduced or absent if there is time.
Do preoperative FBC and U&Es
In other cases a urethral swab for STIs may be appropriate as gonorrhoea and chlamydia are common causes of epididymo-orchitis
how would you differentiate testicular torsion from epididymo-orchitis
Both cause unilateral testicular pain.
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What is Prehn’s Sign?
Prehn’s sign is positive when elevation of the testes with the patient in a supine position relieves the testicular pain,
THIS IS NOT SEEN ON TESTICULAR TORTION
VIVA: Torsion of the Hydatid of Morgangi
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VIVA: Mumps Orchitis
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VIVA: Idiopathic Scrotal Oedema
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VIVA: Testicular Trauma
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VIVA: Testicular Tumours
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