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Urology > Scrotal and Testicular Disorders > Flashcards

Scrotal and Testicular Disorders Flashcards

1
Q

Undescended testes or absent testes (agenesis). Occurs when one or both of the testicles fail to move down into the scrotal sac

A

Cryptorchidism

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2
Q

What is the incidence of cryptorchidism directly related to?

A

birth weight and gestational age

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3
Q

When does spontaneous descent of an undescended testicle usually occur?

A

during 1st three months, rarely after 6 months

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4
Q

Long-term consequences of cryptorchidism

A

infertility, malignancy, inguinal hernias, testicular torsion

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5
Q

How do you differentiate between undescended and retractable testes?

A

retractable are palpable at birth, palpation in warm room can bring them down, and assume scrotal position at puberty

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6
Q

Excess fluid collects between the layers of the tunica vaginalis usually peritoneal fluid due to a weakness in the patent processus vaginalis

A

hydrocele

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7
Q

What are primary congenital hydroceles associated with?

A

indirect inguinal hernia

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8
Q

How long do you wait before doing surgical treatment of a hydrocele?

A

2 yrs

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9
Q

How should you evaluate a suspected hyrocele?

A

transillumination first. ultrasound if transillumination fails

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10
Q

What should a hydrocele in a young man be considered until proven otherwise?

A

cancer

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11
Q

Symptoms associated with a hydrocele

A

heaviness in the scrotum and pain in the lower back

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12
Q

Accumulation of blood in the tunica vaginalis. Can compromise testicle. Causes scrotal skin to become dark red or purple

A

hematocele

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13
Q

Painless, sperm-containing cyst that forms at the end of the epididymis. Located above and posterior to the testes. Attached to the epididymis

A

spermatocele

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14
Q

What is the treatment for a spermatocele if it has become painful?

A

excision

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15
Q

Cause of varicocele that results from damage to the elastic fibers and hypertrophy of vein walls

A

varicosities of the pampiniform plexus

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16
Q

Age group usually affected by varicoceles

A

15-35 yrs

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17
Q

Why are varicoceles more common in the left testicle besides presence of more incompetent valves?

A

left internal spermatic vein inserts renal vein at right angle and force of gravity from upright position causes venous dilatation.

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18
Q

Typically disappears in the supine position and feels like a bag of worms on palpations

A

varicocele

19
Q

What is the surgical treatment for a varicocele in males showing testicular atrophy?

A

liagation of the gonadal vein

20
Q

Twisting of the testes on the long axis of the tunica vaginalis rotates about the spermatic cord. usually presents before 18yrs. Urological emergency

A

testicular torsion

21
Q

Patient presents with N/V, tachycardia, large/firm/tender testes with pain radiating to inguinal area. cremasteric reflex is absent. what should you order?

A

Color Doppler ultrasonography and emergent urology referral since this is the presentation for testicular torsion

22
Q

Because most torsions twist inward and toward the midline, which way should you twist for manual detorsion?

A

outward and laterally

23
Q

What STIs are associated with epididymitis?

A

gonorrhea and chlamydia

24
Q

What bacteria are involved with non-sexually transmitted epididymitis that is associated with UTIs and prostatitis?

A

e. coli, pseudo, gram (+) cocci

25
Q

Patient presents with unilateral pain/swelling of testes. Erythema and edema of scrotal skin, fever, and dysuria. What tests should you order?

A

CBC, UA w/culture, urethral culture (or NAAT), gram stain. This is presentation for epididymitis

26
Q

Treatment for epididymitis besides antibiotics

A

bedrest, scrotal elevation, avoid sexual activity until sx resolve

27
Q

Infection of the testes. Caused by primary infection of the GU tract or infection spread to the testes through the bloodstream or lymphatics

A

orchitis

28
Q

Systemic source of orchitis that doesn’t occur in prepubertal boys, but affects 20-35% of adolescent boys/young men

A

parotitis (mumps)

29
Q

Patient presents with fever, painfully enlarged testes with small hemorrhages into the tunica abluginia, but no urinary symptoms. What is the best management?

A

none, course for orchitis is 7-10 days and unpredictable

30
Q

What are the potential residual effects of orchitis?

A

hyalinization of the seminiferous tubules and testicular atrophy

31
Q

What is the difference between scrotal and testes tumors?

A

benign scrotal tumors are common (carcinoma is rare) whereas nearly all tumors of the testes are malignant

32
Q

Patient who is a road pavement worker presents with a scrotal ulceration that he says used to be a “wart.” What are his treatment options?

A

excision of tumor w/inguinal and femoral node dissection (this is scrotal cancer)

33
Q

Most common cancer in 15-35 yr age group that is highly curable if discovered and preventable by monthly self-testicular exams

A

testicular cancer

34
Q

Strongest predisposing factor to testicular cancer

A

cryptorchidism

35
Q

Most common type of testicular tumor. Confined to the testicle at the time of presentation. Grow slowly and do not spread rapidly. Arises from seminiferous epithelium

A

seminomas

36
Q

Nonseminoma that most commonly affects boys up to 3 yrs of age

A

yolk cell carcinoma

37
Q

Nonseminoma that occurs in 20-30 yr age group

A

embryonal carcinoma

38
Q

Patient presents with solid, painless testicular mass that doesn’t transilluminate. What is your next step?

A

order testicular ultrasound

39
Q

What is the only way to confirm the diagnosis of testicular cancer?

A

inguinal orchiectomy

40
Q

Metastases sites for testicular cancer

A

retroperitoneal lymph nodes, liver, lung, brain

41
Q

Blood tests used in the process of staging testicular cancer and help monitor response to therapy (often first sign of relapse)

A

alpha-fetoprotein (AFP), hCG, lactic dehydrogenase (LDH)

42
Q

Describe the stages of testicular cancer

A

1-cancer is limited to testis. 2- cancer has metastasized to lymph nodes. 3- cancer has spread to other organs

43
Q

When does relapse of testicular cancer usually occur?

A

within two years

Urology (14 decks)

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