Testicular Disease Flashcards
WWhat are the two large groups of patholgies in the scrotum and testis and what must these be assumed as?
Scrotal lump - cancer until proven otherwise
Acute tender testies - torsion until proven otherwise
What three questions must you ask yourself when diagnosing scrotal masses?
Can i get above it?
Is it separate from the testes?
Cystic or solid?
In the scrotal masses what does it mean if you cannot get above it?
Inguinal hernia or hydrocele
In the scrotal masses what does it mean if the mass is separate from the testis and cystic?
epididymal cyst
In the scrotal masses what does it mean if the mass is separate from the testis and solid?
epididymitis/orchitis/varicolele
In the scrotal masses what does it mean if the mass is testicular and cystic?
hydrocele
In the scrotal masses what does it mean if the mass is testicular and solid?
tumor, orchitis, haematocele
What are the features of epididymal cysts?
develop in adulthood
separate from testis and cystic
can be spermatocele
only remove if symptomatic
What is a hydrocele?
fluid within the tunica vaginalis
How can a hydrocele be treated?
watch and wait
aspiration
plication of tunica vaginalis (Lords procedure)
How do you diagnose scrotal masses?
USS
What is the most common cause of epididymitis and orchitis?
chamlydia
What are the features of epididymitis and orchitis?
sudden onset, assoc. fever
How should orchitis be treated in patients under 35 years old?
Doxycyclin to cover chlamydia`
What is a varicocele?
dilitation of the pampiniform plexus.
What are the features of a varicocele?
visible distended blood vessels in scrotum, dull ache,
What is a haematocele/
Blood in the tunica vaginalis
What are the commonest malignancies of the testis?
seminoma
teratoma
tumors of sertoli or leydig cells
How does testicular cancer present?
painless testicular lump, haematospermia, mets of lung
What are the risk factors for getting a testicular tumour?
male aged 15-44
undecended testicals
infant hernia
How would you test a testicular tumour?
biopsy,
CT,
blood for alphafetoprotein, B humanchorionic gonadotrophin
How is testicular cancer treated?
orchidectomy
radio
chemo
What are the symptoms of testicular torsion?
sudden onset of pain in one testis,
uncomfortable walking
pain in abdo, nausea and vomiting
what are the signs of testicular torsion?
red hot swollen testis
How would you test for testicular torsin?
if in any doubt straight to surgery
Doppler USS
How do you treat testicular torsion?
gain consent for an orchidectomy then proceed to fo a bilateral fixation.
What is prehn’s sign and what does it mean?
Pain diminishes from testis on lifting, positive is indicitve of torsion
