S2: Scrotal Swelling Flashcards
1
Q
Anatomy of Scrotum
A
2
Q
Renovasculature of Scrotum
A
3
Q
Common Painful Scrotal Conditions (Acute Scrotum)
A
4
Q
Epidemeology of Testicular torsion
A
5
Q
Pathophysiology of Testicular torsion
A
6
Q
RF for Testicular torsion
A
- Cold weather
- Cryptorchoid testicles
Not Related to Scrotal Trauma
7
Q
Types of Testicular torsion
A
8
Q
CP of Testicular torsion
A
9
Q
Dx of Testicular torsion
A
- Clinically (Mainly)
- Doppler US
10
Q
Color Doppler US in Testicular torsion
A
11
Q
Management of Testicular torsion
A
12
Q
DDx of Testicular torsion
A
13
Q
Epidemeology of Acute Epididymo-orchitis
A
Common in sexually active young adults.
14
Q
Etiology (RF) of Acute Epididymo-orchitis
A
15
Q
Recurrent non resolving inflammation in young males may indicate …….
A
malignancy
16
Q
Dx of Acute Epididymo-orchitis
A
- Clinically
- Color Doppler US
17
Q
CP of Acute Epididymo-orchitis
A
18
Q
Color Doppler US in Acute Epididymo-orchitis
A
Color doppler U.S shows Hypervascularitv.
19
Q
Management of Acute Epididymo-orchitis
A
20
Q
Epidemeology of Torsion of Testicular Appendix
A
- Most common cause of acute scrotun
21
Q
What is testicular appendix?
A
Vestige of embryonic remnant.
22
Q
Dx of Torsion of Testicular Appendix
A
- Clinically
- Doppler US
23
Q
CP of Torsion of Testicular Appendix
A
Blue dot sign
24
Q
Color Doppler US in Torsion of Testicular Appendix
A
Color doppler U.S shows Intact vascularity.
25
Management of **Torsion of Testicular Appendix**
- Not urological emergency (Self-limited).
- If Torsion could not be excluded → Exploration
26
Def of **Varicocele**
- Abnormal dilatation & tortuosity of pampiniform plexus of veins.
27
Epidemeology of **Varicocele**
28
Site of **Varicocele**
29
Etiology of **Varicocele**
30
Complications (Consequences) of **Varicocele**
31
CP of **Varicocele**
32
Grading of **Varicocele**
33
How to clinically suspect Secondary Varicocele?
34
INVx for Varicocele
35
INVx for **Varicocele**
- Doppler Us
36
Management of **Varicocele**
37
Management of **Varicocele**
- Main Line
Conservative
38
Management of **Varicocele**
- Indications of Surgery
39
Management of **Varicocele**
- Aim of Surgical TTT
Ligation of all dilated veins.
40
Management of **Varicocele**
- Techniques of Surgical TTT
- Open varicocelectomy (Palomo operation).
- Laparoscopic varicocelectomy.
- Microsurgical technique.
- Embolization technique (Intervention radiology).
41
Management of **Varicocele**
- Surgical Complications
Surgical complications:
- Recurrence (Main problem)
- Hydrocele.
- Testicular artery injury.
42
Def of **Hydrocele**
Abnorma(fluid collection)between the 2 layers of tunica vaginalis)
43
Type of Fluid in **Hydrocele**
Transudate, exudate or lymphatic.
44
Types of **Hydrocele**
Hydrocele may be:
1. Primary or secondary.
2. Communicating or non (Processes vaginalis).
45
Dx of **Hydrocele**
46
Management of **Hydrocele**
47
Management of **Hydrocele**
- Infantile Hydrocele
Observe for 2 years » Resolve.
48
Management of **Hydrocele**
- If Associated with hernia
Herniotomy
49
Management of **Hydrocele**
- Unexplained Hydrocele in young male (Alarming)
You have to exclude Testicular tumor.
50
Management of **Hydrocele**
- Adult male with large hydrocele
Hydrocelectomy:
- Eversion or Tunica vaginalis (Jaboulay operation).
- Lords operation.
51
Epidemeology of **Testicular Tumors**
52
RF for **Testicular Tumors**
53
Pathology in **Testicular Tumors**
54
Pathology in **Testicular Tumors**
- Seminoma
Most common (60%)
55
Pathology in **Testicular Tumors**
- NSGCT
1) Teratoma.
2) Yolk sac tumors.
3) Embryonal carcinoma.
4) Choriocarcinoma.
56
Pathology in **Testicular Tumors**
- Sex Cord / Stromal Tumors
- Leydig cell tumors.
- Granulosa cell tumors.
- Sertoli cell tumors.
- Mixed GCT (Gonadoblastoma).
57
Pathology in **Testicular Tumors**
- Miscellaneous Tumors
- Secondary mets.
- Lymphoma.
- Epididymal tumors.
- Mesothelioma.
58
CP of **Testicular Tumors**
59
CP of **Testicular Tumors**
- Painless Scrotal Swelling
...
60
CP of **Testicular Tumors**
- Occult Presentation
A. 2ry Hydrocele.
B. Subfertility.
C. Recurrent inflammation.
D. Acute abdomen.
61
CP of **Testicular Tumors**
- Do Not Forget to look At ....
A. Left side of the neck → Vircow L.N.
B. Breast → Cynecomastia (Choriocarcinoma, MCQ,
C. L.L → Edema (Lymphatic obstruction)
62
CP of **Testicular Tumors**
- manifestations of Mets
10 %
63
Staging of **Testicular Tumors**
64
Staging of **Testicular Tumors**
- T
65
Staging of **Testicular Tumors**
- N
66
Staging of **Testicular Tumors**
- M
67
Landing Zones in **Testicular Tumors**
68
INVx in **Testicular Tumors**
- Doppler US
- CT
- Tumor Markers
69
INVx in **Testicular Tumors**
- Doppler US
Scrotal doppler U.S on both testicles → Confirm diagnosis.
70
INVx in **Testicular Tumors**
- CT
CT with contrast chest, abdomen and pelvis → Stagging.
71
INVx in **Testicular Tumors**
- Tumor Markers
72
INVx in **Testicular Tumors**
- AFP
- Never with seminoma
- Never with choriocarcinoma
- > 50% of cases of NSGCT
73
INVx in **Testicular Tumors**
- B-HCG
- 1/3 cases of seminoma
- 1/2 cases NSGCT
- All cases of Choriocarcinoma
74
INVx in **Testicular Tumors**
- LDH
Non specific (Follow up)
75
INVx in **Testicular Tumors**
- No Role For .....
- MRI.
- Bone scan.
- Biopsy.
76
Etiology of **Hematocele**
- Trauma.
- Post-surgical.
77
Def of **Hematocele**
Collection of blood within the scrotal sac but not inside the testicles.
78
Plan for Management of **Testicular Tumors**
79
TTT of **Hematocele**
80
Def of **Spermatocele**
Abnormal sac (cyst) that develops in the epididymis.
81
CP of **Spermatocele**
- Noncancerous & generally painless.
- A spermatocele usually is filled with milky or clear fluid that might contain sperm.
82
TTT of **Spermatocele**
No TTT
