scrotal lumps

Question 1

presentation of hydrocele

Answer 1

painless, soft scrotal swelling
testes are palpable
soft, fluctuant may be large
transluminates

Question 2

varicocele presentation

Answer 2

throbbing dull pain
worse on standing 
dragging sensation 
BAG OF WORMS
disappears on lying down- if not then concerning

Question 3

epididymal cyst presentation

Answer 3

asymptomatic
Soft, round lump at the top of the testicle
found incidentally on ultrasound
May be able to transilluminate large cysts

Question 4

testicular cancer presentation

Answer 4

painless lump
non-tender, arising from testicle
hard
irregular

Question 5

Epididymo-orchitis causes

Answer 5

Escherichia coli (E. coli)
Chlamydia trachomatis
Neisseria gonorrhoea
Mumps

Question 6

Epididymo-orchitis presentation

Answer 6

gradual onset, over minutes to hours
unilateral testicular pain
Dragging or heavy sensation
Tenderness on palpation

Question 7

testicular torsion presentation

Answer 7

rapid onset, unilateral testicular pain
firm swollen testicle
elevated testicle
Absent cremasteric reflex
Abnormal testicular lie (often horizontal)
Rotation, so that epididymis is not in normal posterior position

Question 8

what can a left sided varicocele indicate?

Answer 8

renal cell carcinoma

Question 9

investigations for varicoceles

Answer 9

ultrasound with doppler to confirm diagnosis
semen analysis for concerns about fertility
hormonal tests (FSH and testosterone)

Question 10

associated conditions with epididymal cysts

Answer 10

polycystic kidney disease
cystic fibrosis
von hippel-lindau syndrome