Male reproductive pathology Flashcards
What is a hydrocele?
Collection of fluid between the two layers of the tunica vaginalis (mesothelial lining which surrounds the testes)
How does hydrocele present?
- Soft, smooth, non-tender swelling around one of the testes
- Transilluminate with light on examination with a pen torch
What is meant by simple hydrocele?
no connection with peritoneal cavity
What is meant by communicating hydrocele?
have a connection with the peritoneal cavity
How is simple hydrocele managed?
Usually resolve within 2 years without having any lasting negative effects
No surgical management required
How are communicating hydroceles managed?
Surgery
What is a spermatocele?
Fluid-filled cyst that develops at the head of the epididymis
How does spermatocele present?
- Unknown cause and usually asymptomatic
- May feel a fullness
- Often present after self-examination
How are spermatoceles managed?
- Smaller/asymptomatic cysts are left alone
- Treatment options (medication, aspiration, surgery) can be considered if cysts are causing pain or are enlarging
What is a varicocele?
Abnormal enlargement of the pampiniform venous plexus in the scrotum
How do varicoceles present?
- Usually asymptomatic
- May present having felt a lump
- Large varicoceles present as plexus of veins and may be described as ‘bag of worms’
Which testicle is most commonly affected by varicocele?
Left
Why is the left testicle most commonly affected by varicocele?
- Most commonly affects the left side of the scrotum, due to increased resistance to flow
- Left gonadal vein drains into the left renal vein whereas the right gonadal vein drains directly into the inferior vena cava
How is varicocele managed?
- Generally need no treatment
- If causing pain or swelling consider surgical management
