Scrotal Lump

Question 1

What is a scrotal lump?

Answer 1

Abnormal mass or swelling in scrotum

Question 2

Important history points for a scrotal lump

Answer 2

Time of onset
Associated symptoms
Previous episodes

Inspect lump

• site
• size
• shape
• symmetry
• skin changes
• scars

Question 3

Extra-testicular causes for a scrotal lump

Answer 3

Hydrocoele 
Varicocoele 
Epididymal cyst 
Epidiymitis 
Inguinal hernia

Question 4

Testicular causes for a scrotal lump

Answer 4

Testicular cancer
Testicular torsion
Orchitis

Question 5

What is hydrocoele?

Answer 5

Abnormal collection of peritoneal fluid between parietal and visceral layers of tunica vaginalis

Question 6

How does hydorcoele present?

Answer 6

Painless fluctuant swelling

Transillumiates

Question 7

What is varicocoele?

Answer 7

Abnormal dilatation of pampiniform plexus

Present feeling like ‘bag of worms’

Question 8

What are epididymal cysts?

Answer 8

Benign fluid filled sacs arising from epididymis

Smooth fluctuant nodule
Transilluminates

Commonly seen in middle aged men

Question 9

What is epididymitis?

Answer 9

Inflammation of epididymis

Unilateral acute onset scrotal pain

Treated with analgesia and oral antibiotics

Question 10

What is orchitis?

Answer 10

Inflammation of testis

Question 11

What is testicular torsion?

Answer 11

Twisting of the testis on the spermatic cord

Sudden onset very severe unilateral scrotal pain
Affected testis = raised, tender, swollen

Surgical emergency - treated within 6 hours