Other Scrotal Abnormalities

Question 1

What are a few general considerations of other scrotal abnormalities?

Answer 1

Malignancy is often painless

Tense hydrocele or spermatocele must be differentiated from a tumor

Conditions causing painless scrotal swelling are not true emergencies.
If testicular tumors are found must be immediately treated.

Question 2

What is a varicocele?

Answer 2

Dilation of the pampiniform plexus of spermatic veins and is generally left sided.

Usually asymptomatic.
Mass is separate form testis.
Feels like bag of worms
Size increased by valsalva
Right sided varicocele should raise suspicion for inferior vena cava and infra abdominal pathology
Sudden left sided varicocele should raise suspicion for left renal vein obstruction, or renal tumor.

Question 3

What is a hydrocele?

Answer 3

Collection of peritoneal fluid between the parietal and visceral layers around the testes and spermatic cord.

Gradually enlarging painless cystic mass that transilluminates
May indicate tumor

Question 4

What is a spermatocele?

Answer 4

Fluid filled cyst at the head of the epididymis that may contain nonviable sperm.
Painless
Palpated as distinct from testis
Typically transilluminates as cystic in nature

Question 5

What is the best imaging technique?

Answer 5

Ultrasound