Scrotal Lumps

Question 1

What is a hydrocele?

Answer 1

A hydrocele is an accumulation of fluid in the tunica vaginalis, leading to scrotal swelling.

Question 2

How does a hydrocele typically present on examination?

Answer 2

It presents as a smooth, firm mass that transilluminates and may make the testicle impalpable if large.

Question 3

What is a varicocele?

Answer 3

A varicocele is an abnormal dilatation of veins in the pampiniform venous plexus within the scrotum.

Question 4

How does a varicocele feel on palpation?

Answer 4

It often feels like a “bag of worms” and may be more prominent when standing or with increased intra-abdominal pressure.

Question 5

What is a spermatocele?

Answer 5

A spermatocele is a benign cystic accumulation of sperm that arises from the head of the epididymis.

Question 6

How does a spermatocele present clinically?

Answer 6

It presents as a painless, cystic mass separate from the testis and typically transilluminates.

Question 7

What is an epididymal cyst?

Answer 7

An epididymal cyst is a benign fluid-filled sac arising from the epididymis, containing clear serous fluid.

Question 8

How can you differentiate an epididymal cyst from a spermatocele?

Answer 8

Both present similarly; however, epididymal cysts contain clear fluid, while spermatoceles contain sperm.

Question 9

What is epididymitis?

Answer 9

Epididymitis is inflammation of the epididymis, often due to infection.

Question 10

What are common symptoms of epididymitis?

Answer 10

Symptoms include scrotal pain, swelling, erythema, and sometimes fever.

Question 11

What is testicular torsion?

Answer 11

Testicular torsion is the twisting of the spermatic cord, leading to compromised blood flow to the testicle.

Question 12

How does testicular torsion present?

Answer 12

It presents with sudden, severe scrotal pain, swelling, and an elevated testicle; it is a surgical emergency.

Question 13

What is testicular cancer?

Answer 13

Testicular cancer is a malignant growth within the testicle, most common in men aged 15-45 years.

Question 14

How does testicular cancer typically present?

Answer 14

It often presents as a painless, hard testicular mass that does not transilluminate.

Question 15

What is an inguinal hernia?

Answer 15

An inguinal hernia occurs when abdominal contents protrude through the inguinal canal into the scrotum.

Question 16

How can an inguinal hernia be identified during examination?

Answer 16

It may present as a scrotal mass that increases with coughing or straining and may be reducible.

Question 17

What is the significance of transillumination in evaluating scrotal masses?

Answer 17

Transillumination helps differentiate cystic (e.g., hydrocele) from solid masses (e.g., testicular tumour); cystic masses typically transilluminate.

Question 18

What is Fournier’s gangrene?

Answer 18

Fournier’s gangrene is a rapidly progressing necrotizing fasciitis of the perineum and scrotum, requiring emergency treatment.

Question 19

What are common risk factors for Fournier’s gangrene?

Answer 19

Risk factors include diabetes mellitus, immunosuppression, and local trauma or infection.

Question 20

What is a scrotal abscess?

Answer 20

A scrotal abscess is a localized collection of pus within the scrotal tissues, often due to infection.

Question 21

How does a scrotal abscess present clinically?

Answer 21

It presents with scrotal pain, swelling, erythema, and may have fluctuance on palpation.

Question 22

What is a haematocele?

Answer 22

A haematocele is an accumulation of blood within the tunica vaginalis, usually due to trauma.

Question 23

How does a haematocele differ from a hydrocele on examination?

Answer 23

Unlike a hydrocele, a haematocele does not transilluminate and may be tender if acute.

Question 24

What is a scrotal lipoma?

Answer 24

A scrotal lipoma is a benign tumour composed of fat cells, often presenting as a soft, non-tender mass.

Question 25

What is the “silk glove sign” associated with?

Answer 25

The “silk glove sign” is associated with an indirect inguinal hernia, felt as a thickened processus vaginalis during examination.