Scrotal Mass Flashcards
What questions must you ask about this scrotal mass?
- Is the lump painful?
- How long has lump been there?
- What made the patient first notice the lump?
- Has the lump gotten bigger, smaller or stayed the same size?
- Is the lump always there
- Any other lumps
- Does he have any other symptoms
- Any trauma to the testes
- Do testes feel heavy
What would an acute swollen and tender scrotum suggest?
testicular torsion until proven othersie
Is a testicular malignancy painful?
no
What would a scrotal mass that has been there for hours suggest?
testicular torsion
What could a scrotal mass that has been there weeks/months suggest?
testicular tumour
How would an inguinal hernia change with movement?
can extend to scrotum during exertion or long period of standing (increase in intra-abdominal pressure)
What scrotal mass differential varies in size throughout the day and disappears when lying down?
varicoceles
What other symptoms would you enquire about?
- UTI symptoms
2. STI symptoms
What are common UTI symptoms?
- dysuria
- polyuria
- suprapubic pain
- offensive smelling urine
- urgency
- strangury
- haematuria
What could STI symptoms be?
purulent urethral discharge
Why do you ask if the testes feel heavy?
raise sus of cancer
What are 4 key characteristics to ask about to narrow differential diagnosis scrotal mass?
- Can you get above it? Is swelling confined to scrotum or does it extend proximally into groin?
- Is it possible to palpate the testis seperately from the swelling/lump?
- Does it transilluminate?
- Is the mass tender?
What would an extension of a mass into the groin suggest?
inguinoscrotal hernia
What features should you try to indentify on palpitation?
- spermatic cord
- epidiymis
- testis
- (if you can’t due to the lump, try to see which of remaining structures you can palpate)
Which types of masses glow?
fluid