Testicular and Scrotal Disease Flashcards
Does testicular cancer usually present with local or metastatic disease?
Local
What is the best imaging modality for the scrotum?
US
What is crypto-orchidism?
Non-descending, dysplastic testes
Increased risk of cancer
How can you tell if a lump arises in the scrotom or abdomen?
Can you get above it when squeezing
DDx for painless scrotal lumps?
Hydrocele
Epididymo-orchidis
Epididymal cyst
Inguinal hernia
Varicocele
Benign tumour
Malignancy - Primary, lymphoma
What are some infective causes of epididymo-orchidis?
Gonorrhoea
Chlamydia
E. coli
Mumps
Coxsachie
TB
BCG
How are testicular cancers characterised?
Germcell (95-99%) and non-germcell
What are the classic examination findings of testicular torsion?
Loss of cremasteric reflex
Loss of orientation of the testes
Tender, firm testicle that is high riding
How do you assess a scrotal lump on Hx?
Hx
- Time course
- Associated features: pain, discharge, fever, salivary glands
- Association with coughing and lying/standing
- FHx
- ?Crypto-orchidism (non descending, dysplasic testes)
- ?STI or UTI
Which type of cancers cause cannon mets in the lung?
Testicular
Renal cell cancer
Why do you ask about the size of a patient’s salivary glands?
Looking for mumps as a cause of epididymo-orchitis
What are some types of germcell tumours?
Seminoma
Non-seminoma
How do urine samples differ when looking for UTI vs STI?
UTI - midstream
STI - fall pass/urethral swob
How do you assess a scrotal lump on examination?
General inspection - fever
Abdominal exam
Inguinal exam
- Erythema
- Translumination - simple fluids transluminate
Feel the lump
- Hard/soft
- Reducible
- Position in relation to other structures
DDx for acute scrotum?
Testicular torsion
Torsion of testicular appendage
Epididymitis
Trauma
Incarcerated hernia
