Scrotal lumps Flashcards
What are causes?
Hydrocele
Varicocele
Epididymal cyst
Testicular cancer
Epididymo-orchitis
Inguinal hernia
Testicular torsion
What is a hydrocele
Collection of fluid within the tunica vaginalis that surrounds the testes
What are examination findings of hydrocele?
Testicle palpable within the hydrocele
Soft, fluctuant
Irreducible, no bowel sounds, distinguishes from hernia
Transilluminates
What are causes of hydroceles?
Idiopathic
testicular cancer
Testicular torsion
epididymo-orchitis
Trauma
What is management of hydrocele? When is intervention required?
Exclude serious causes
Surgery, aspiration or sclerotherapy in large or symptomatic cases
What is varicocele
Veins in pampiniform plexus become swollen
What is the pampiniform plexus and its function>
Drains into testicular vein
Regulates temperature of the blood entering testicle by absorbing heat from nearby artery
What side to varicoceles tend to occur on and why?
Left due to increased resistance in the left testicular vein
What should you be cautious about with a diagnosis of left sided varicocele and why?T
Renal cell carcinoma as left sided varicocele can indicate obstruction of the left testicular vein
How do varicoceles present?
throbbing dull pain worse on standing
Dragging sensation
Infertility
Examination findings of varicocele
Scrotal mass feeling like a bag of worms
More on standing
Disappears on lying down
Asymmetry of testicular size if varicocele has affected growth of the testicle
What features would make you suspicious of malignancy in varicocele?
If they dont disappear on lying down
Left sided
What investigations would you consider with varicocele?
USS with doppler imaging
Semen analysis fi concerns of fertility
Hormonal tests
How are varicoceles managed
Conservative
Surgery or endovascular embolisation
How do epididymal cysts present
Can be asymptomatic
Lump
Incidentally on USS
