T4-L2: Male Urological Pathology

Question 1

What is cryptorchidism?

Answer 1

An undescended testes - the testes is not in the scrotum. It can be classified based on where the testes is. It can be in the high scotum, inguinal canal and abdomen.

Question 2

Why is cryptorchidism seem most commonly in preterm babies?

Answer 2

At 10 weeks the testes have transabdominal descent. From 25-35 weeks they have inguinoscrotal descent. The reason whey premature babies have an undescended testes is because many are grown at this time.

Question 3

What are potent complications of cryptorchidism?

Answer 3

Infertility, hernias, testicular cancer risk, testicular torsion (the mechanisms preventing torsion is that the testes is properly secured but since it descended later these attachments may not be found).

Question 4

What is the epidemiology of seminoma?

Answer 4

Seminoma - malignant neoplasm of the testes in the seminiferous tubules.

Epidemiology.

- Disease of young men (25-45)
- Family history 
- Cryptorchidism

Question 5

What are the clinical features of seminoma?

Answer 5

Clinical features:
- Local primary tumour effects - dull ache or pain, shrinking, increased firmness, welling/enlargement, heavy feeling, hard lump, difference between testacies and fluid

- Effects of distant metastases - lung mets (SOB etc. ) and lymph node mets (back pain - tend to be those in the abdominal and mediastinum)
- Paraneoplastic syndromes - gynecomastia (beta HCG)

Question 6

Give symptoms of urinary tract obstruction and complications that may arise.

Answer 6

Symptoms of Urinary Tract Obstruction

- Complete obstruction - anuria and pain 
- Partial obstructions are often asymptomatic 

Complications

- Irreversible renal impairment and secondary VUR (vesicoureteral pressure) due to back pressure 
- Infection and calculi formation (stone) can occur due to urinary stasis