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Y4R4 - Surgery II 👨‍⚕️ > S2: Scrotal Swelling > Flashcards

S2: Scrotal Swelling Flashcards

1
Q

Anatomy of Scrotum

A
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2
Q

Renovasculature of Scrotum

A
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3
Q

Common Painful Scrotal Conditions (Acute Scrotum)

A
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4
Q

Epidemeology of Testicular torsion

A
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5
Q

Pathophysiology of Testicular torsion

A
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6
Q

RF for Testicular torsion

A
  • Cold weather
  • Cryptorchoid testicles

Not Related to Scrotal Trauma

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7
Q

Types of Testicular torsion

A
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8
Q

CP of Testicular torsion

A
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9
Q

Dx of Testicular torsion

A
  • Clinically (Mainly)
  • Doppler US
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10
Q

Color Doppler US in Testicular torsion

A
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11
Q

Management of Testicular torsion

A
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12
Q

DDx of Testicular torsion

A
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13
Q

Epidemeology of Acute Epididymo-orchitis

A

Common in sexually active young adults.

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14
Q

Etiology (RF) of Acute Epididymo-orchitis

A
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15
Q

Recurrent non resolving inflammation in young males may indicate …….

A

malignancy

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16
Q

Dx of Acute Epididymo-orchitis

A
  • Clinically
  • Color Doppler US
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17
Q

CP of Acute Epididymo-orchitis

A
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18
Q

Color Doppler US in Acute Epididymo-orchitis

A

Color doppler U.S shows Hypervascularitv.

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19
Q

Management of Acute Epididymo-orchitis

A
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20
Q

Epidemeology of Torsion of Testicular Appendix

A
  • Most common cause of acute scrotun
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21
Q

What is testicular appendix?

A

Vestige of embryonic remnant.

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22
Q

Dx of Torsion of Testicular Appendix

A
  • Clinically
  • Doppler US
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23
Q

CP of Torsion of Testicular Appendix

A

Blue dot sign

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24
Q

Color Doppler US in Torsion of Testicular Appendix

A

Color doppler U.S shows Intact vascularity.

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25
Q

Management of Torsion of Testicular Appendix

A
  • Not urological emergency (Self-limited).
  • If Torsion could not be excluded → Exploration
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26
Q

Def of Varicocele

A
  • Abnormal dilatation & tortuosity of pampiniform plexus of veins.
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27
Q

Epidemeology of Varicocele

A
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28
Q

Site of Varicocele

A
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29
Q

Etiology of Varicocele

A
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30
Q

Complications (Consequences) of Varicocele

A
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31
Q

CP of Varicocele

A
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32
Q

Grading of Varicocele

A
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33
Q

How to clinically suspect Secondary Varicocele?

34
Q

INVx for Varicocele

35
Q

INVx for Varicocele

  • Doppler Us
36
Q

Management of Varicocele

37
Q

Management of Varicocele

  • Main Line
A

Conservative

38
Q

Management of Varicocele

  • Indications of Surgery
39
Q

Management of Varicocele

  • Aim of Surgical TTT
A

Ligation of all dilated veins.

40
Q

Management of Varicocele

  • Techniques of Surgical TTT
A
  • Open varicocelectomy (Palomo operation).
  • Laparoscopic varicocelectomy.
  • Microsurgical technique.
  • Embolization technique (Intervention radiology).
41
Q

Management of Varicocele

  • Surgical Complications
A

Surgical complications:

  • Recurrence (Main problem)
  • Hydrocele.
  • Testicular artery injury.
42
Q

Def of Hydrocele

A

Abnorma(fluid collection)between the 2 layers of tunica vaginalis)

43
Q

Type of Fluid in Hydrocele

A

Transudate, exudate or lymphatic.

44
Q

Types of Hydrocele

A

Hydrocele may be:
1. Primary or secondary.
2. Communicating or non (Processes vaginalis).

45
Q

Dx of Hydrocele

46
Q

Management of Hydrocele

47
Q

Management of Hydrocele

  • Infantile Hydrocele
A

Observe for 2 years » Resolve.

48
Q

Management of Hydrocele

  • If Associated with hernia
A

Herniotomy

49
Q

Management of Hydrocele

  • Unexplained Hydrocele in young male (Alarming)
A

You have to exclude Testicular tumor.

50
Q

Management of Hydrocele

  • Adult male with large hydrocele
A

Hydrocelectomy:

  • Eversion or Tunica vaginalis (Jaboulay operation).
  • Lords operation.
51
Q

Epidemeology of Testicular Tumors

52
Q

RF for Testicular Tumors

53
Q

Pathology in Testicular Tumors

54
Q

Pathology in Testicular Tumors

  • Seminoma
A

Most common (60%)

55
Q

Pathology in Testicular Tumors

  • NSGCT
A

1) Teratoma.

2) Yolk sac tumors.

3) Embryonal carcinoma.

4) Choriocarcinoma.

56
Q

Pathology in Testicular Tumors

  • Sex Cord / Stromal Tumors
A
  • Leydig cell tumors.
  • Granulosa cell tumors.
  • Sertoli cell tumors.
  • Mixed GCT (Gonadoblastoma).
57
Q

Pathology in Testicular Tumors

  • Miscellaneous Tumors
A
  • Secondary mets.
  • Lymphoma.
  • Epididymal tumors.
  • Mesothelioma.
58
Q

CP of Testicular Tumors

59
Q

CP of Testicular Tumors

  • Painless Scrotal Swelling
60
Q

CP of Testicular Tumors

  • Occult Presentation
A

A. 2ry Hydrocele.

B. Subfertility.

C. Recurrent inflammation.

D. Acute abdomen.

61
Q

CP of Testicular Tumors

  • Do Not Forget to look At ….
A

A. Left side of the neck → Vircow L.N.

B. Breast → Cynecomastia (Choriocarcinoma, MCQ,

C. L.L → Edema (Lymphatic obstruction)

62
Q

CP of Testicular Tumors

  • manifestations of Mets
63
Q

Staging of Testicular Tumors

64
Q

Staging of Testicular Tumors

  • T
65
Q

Staging of Testicular Tumors

  • N
66
Q

Staging of Testicular Tumors

  • M
67
Q

Landing Zones in Testicular Tumors

68
Q

INVx in Testicular Tumors

A
  • Doppler US
  • CT
  • Tumor Markers
69
Q

INVx in Testicular Tumors

  • Doppler US
A

Scrotal doppler U.S on both testicles → Confirm diagnosis.

70
Q

INVx in Testicular Tumors

  • CT
A

CT with contrast chest, abdomen and pelvis → Stagging.

71
Q

INVx in Testicular Tumors

  • Tumor Markers
72
Q

INVx in Testicular Tumors

  • AFP
A
  • Never with seminoma
  • Never with choriocarcinoma
  • > 50% of cases of NSGCT
73
Q

INVx in Testicular Tumors

  • B-HCG
A
  • 1/3 cases of seminoma
  • 1/2 cases NSGCT
  • All cases of Choriocarcinoma
74
Q

INVx in Testicular Tumors

  • LDH
A

Non specific (Follow up)

75
Q

INVx in Testicular Tumors

  • No Role For …..
A
  • MRI.
  • Bone scan.
  • Biopsy.
76
Q

Etiology of Hematocele

A
  • Trauma.
  • Post-surgical.
77
Q

Def of Hematocele

A

Collection of blood within the scrotal sac but not inside the testicles.

78
Q

Plan for Management of Testicular Tumors

79
Q

TTT of Hematocele

80
Q

Def of Spermatocele

A

Abnormal sac (cyst) that develops in the epididymis.

81
Q

CP of Spermatocele

A
  • Noncancerous & generally painless.
  • A spermatocele usually is filled with milky or clear fluid that might contain sperm.
82
Q

TTT of Spermatocele

Y4R4 - Surgery II 👨‍⚕️ (33 decks)

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