scrotal problems Flashcards
Which scrotal swelling is separate from the body of the testicle and found posterior to the testicle?
Epididymal cyst
Conditions associated with epididymal cysts
polycystic kidney disease
cystic fibrosis
von Hippel-Lindau syndrome
imaging to diagnose epididymal cyst
US
Management of epididymal cyst
- normally supportive
- surgical removal or sclerotherapy if large/ symptomatic cysts.
What testicular swelling is defined as an accumulation of fluid within the tunica vaginalis?
hydrocele
Describe the difference between a communicating an non-communicating hydrocele
Communicating: patency of the processus vaginalis allowing peritoneal fluid to drain into scrotum (common in newborn males)
Non-communicating = excessive fluid production within the tunica vaginalis
What may hydroceles develop secondary to?
epididymo-orchitis
testicular torsion
testicular tumours
Clinical features of hydrocele
- soft, non-tender swelling
- anterior to and below the testicle
- swelling is confined to the scrotum
- you can get ‘above’ the mass on examination
- transilluminates
When is US required to confirm a diagnosis of hydrocele?
- any doubt about the diagnosis
- OR underlying testis cannot be palpated.
Management of hydrocele
- infantile = repaired if not resolved by the age of 1-2 years
Adults = conservative Mx
but make sure to exclude a tumour
What testicular swelling is defined as an abnormal enlargement of the testicular veins.
Varicocele
Are varicoceles more common on the R or L?
Left
How are varicoceles classically described on examination?
‘bag of worms’
what imaging is used for diagnosis of varicocele?
US with Doppler studies
Management of varicocele?
- conservative
- surgery if the patient is troubled by pain
