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2a Genitourinary > Non-cancer Scrotal diseases > Flashcards

Non-cancer Scrotal diseases Flashcards

1
Q

Any scrotal mass should be treated as ____ until proven otherwise

A

cancer

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2
Q

Where is an epidydimal cyst located?

A

Extra testicular cyst, above and behind testis

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3
Q

True or false: an epidydimal cyst will transilluminate?

A

True

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4
Q

How do you diagnose an epidydimal cyst?

A

USS of scrotum

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5
Q

What is an epidydimal cyst containing sperm called?

A

Spermatocele (managed same as epidydimal cyst)

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6
Q

A hydrocele is a fluid collection in the…

A

tunica vaginalis

(originally part of peritoneal membrane, during development of fetus separates and remains in scrotum, partially covering each testicle.)

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7
Q

True or false: a hydrocele will transilluminate

A

True

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8
Q

What is a communicating hydrocele?

A

Tunica vaginalis is connected to the peritoneal cavity via the processus vaginalis allowing fluid to travel from the peritoneal cavity into the hydrocele.

Hydrocele may fluctuate in size.

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9
Q

How do you diagnose a hydrocele?

A

USS of scrotum

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10
Q

What can hydroceles be secondary to?

A

(can be idiopathic)
Testicular cancer
Testicular torsion
Epididymo-orchitis
Trauma

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11
Q

How are hydroceles managed?

A

In new-borns will often recede as liquid is reabsorbed over time.

Can have surgery, aspiration or sclerotherapy in large of symptomatic cases.

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12
Q

Where does the pampiniform plexus drain into?

A

Testicular vein

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13
Q

What is a varicocele?

A

Distended pampiniform plexus veins due to increased resistance in testicular vein and incompetent valves allowing blood to flow back into the pampiniform plexus.

(mass of varicose veins in spermatic cord)

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14
Q

What does the right testicular vein drain into?

A

The inferior vena cava

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15
Q

What does the left testicular vein drain into?

A

The left renal vein

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16
Q

What side is a varicocele mostly found?

A

Left

17
Q

What can a left-sided varicocele indicate?

A

Obstruction of left testicular vein caused be a renal cell carcinoma

18
Q

What is a varicocele often described as?

A

Bag of worms

19
Q

Is a varicocele painful?

A

Rarely when larger and more severe but typically they’re painless.

20
Q

What is a complication of varicocele?

A

Infertility
Probably to do with disrupting temperature of affected testicle.

21
Q

How do you diagnose a varicocele?

A

Physical examination
Doppler USS can provide details image of veins in scrotum.

22
Q

Should a varicocele disappear when lying down?

A

Yes, if not raises alarms of possible retroperitoneal tumours obstructing the drainage of the renal vein.

23
Q

What is testicular distorsion?

A

Spermatic cord twists on itself, occluding the testicular artery causing ischaemia.

24
Q

If testicular distortion is treated, what happens

A

Gangrene of testis

25
Q

What is a risk factor for testicular torsion?

A

Bell clapper deformity (“horizontal lie” of testes)

26
Q

How would a patient with testicular torsion present?

A

Severe uni-testicular pain (hurts to walk)
Abdominal pain
N&V
No pain relief with elevating testis
Cremasteric reflex lost.

27
Q

What is the cremasteric reflex?

A

Stroke inner thigh, ipsilateral testicle should elevate/retract upwards

28
Q

How do you diagnose testicular torsion?

A

1st line = Surgical exploration - emergency
USS to check testicular blood flow

29
Q

How do you treat testicular torsion?

A

urgent surgery within 6 hours (90-100% success rate)

30
Q

What is Prehn’s sign and when is it used?

A

Lifting half of the scrotum to assess consequent change in pain used to determine cause.

Positive = relief of pain
Negative = exacerbation of pain

31
Q

What does a positive Prehn’s sign indicate

A

Relief of pain suggests acute or chronic epididymitis (bacterial infection often from STIs)

32
Q

What does a negative Prehn’s sign indicate?

A

Exacerbation of pain suggests testicular torsion as spermatic cord compressed

2a Genitourinary (28 decks)

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