Penile and testicular conditions Flashcards
What is an absolute indication for circumcision?
BAlanitis xerotica obliterates BXO- scarring condition of foreskin
What are some relative indications for circumcision?
Balanoprosthetis
Recurrent UTI
Phimosis
Religious/cultural- not covered on NHS
What are some suggested advantages of circumcision?
UTI
Malignancy
AIDs/STI
What are some disadvantages of circumcision?
Painful
Complications- bleeding, mental stenosis, fistula
What is an absolute contraindication to circumcision?
Hypospadias- foreskin may be needed in surgical repair
What is the presentation of hydrocele?
Scrotal swelling- bluish colour, transilluminates, increases in size with crying, straining, in evening
Painless
What is the management of hydrocele?
Convervative until age 5
Surgery
What is cryptorchidism?
Undescended testis by 3 months
What are the types of cryptorchidism?
True
Retractile
Ectopic
Ascending
What is the management of cryptorchidism?
Orchidopexy at 6-18 months
What is the management of cryptorchidism in teens?
Orchidectomy- due to high cancer risk
What are the complications of cryptorchidism?
40x as likely to develop testicular cancer
Reduced fertility
What are some causes of acute scrotum?
Testicular torsion- most common in neonates and >15s
Torsion of testicular appendage= most common in children
Epididymitis= seen in neonates and teens, but rarely children
Trauma
HAematocele
Incarcerated inguinal hernia
What is testicular torsion?
Twist in spermatic cord causing testicular ischaemia and necrosis
What age is testicular torsion seen in?
10-30yo
Peak at 13-15
What is the presentation of testicular torsion?
Sudden onset severe pain- not eased by elevation Tenderness of entire testis Swelling and redness Loss of cremaster reflex History of trauma
What is the management of testicular torsion?
Emergency surgical exploration- Fix both testis if one torted
What is the presentation of torsion of testicular appendage?
More gradual onset Pain in one testicle Swelling and redness Cremaster reflex present Blue dot sign
What is the management or torsion of testicular appendage?
Not emergency- analgesia and rest
Emergency surgical exploration if suspect of testicular torsion
What is hypospadias?
Urethral meatus on ventral aspect of penis
What are the classifications of hypospadias?
Anterior= 50% Middle= 30% Posterior= 20%
What is the management of hypospadias?
Corrective surgery before age 2
DO NOT circumcise- use foreskin in procedure
What is chordee and when is it treated?
Bend in penis
Surgery if >15 degrees
