Scrotal Swelling

Question 1

most common cause of scrotal swellings seen in primary care

Answer 1

Epididymal cysts

Question 2

Epididymal cysts features

Answer 2

found posterior to the testicle

discrete soft mass which is pea sized

Question 3

Tx for epididymal cyst

Answer 3

usually supportive but surgical removal or sclerotherapy may be attempted for larger or symptomatic cysts

Question 4

Types of hydrocele?

Answer 4

Communicating hydroceles : are common in newborn malesl
usually resolve within the first few months of life

non-communicating: caused by excessive fluid production within the tunica vaginalis

Question 5

Features of hydrocele

Answer 5

anterior to and below the testicle

swelling is confined to the scrotum, you CAN get ‘above’ the mass on examination

transilluminates with a pen torch

testis difficult to palpate if hydrocele is large

Question 6

Mx of hydrocele ?

Answer 6

infantile hydroceles resolve spontaneously by the age of 1-2 years

If not surgical repair

in adults a conservative approach may be taken depending on the severity of the presentation. Further investigation (e.g. ultrasound) is usually warranted however to exclude any underlying cause such as a tumour

Question 7

varicocele associated with

Answer 7

Infertility

Question 8

What is varicocele ?

Answer 8

abnormal enlargement of the testicular veins

Question 9

Features of varicocele?

Answer 9

diffuse lumpy swelling

Bag of worms

Subfertility

Question 10

Ma of varicocele ?

Answer 10

usually conservative
occasionally surgery is required if the patient is troubled by pain

Question 11

How to differentiate hydrocele to inguinal hernia ?

Answer 11

Hydrocoele you can get above. Inguinal hernia you can’t get above because the hernia has descended into the scrotum.