Testicular Disease

Question 1

WWhat are the two large groups of patholgies in the scrotum and testis and what must these be assumed as?

Answer 1

Scrotal lump - cancer until proven otherwise

Acute tender testies - torsion until proven otherwise

Question 2

What three questions must you ask yourself when diagnosing scrotal masses?

Answer 2

Can i get above it?
Is it separate from the testes?
Cystic or solid?

Question 3

In the scrotal masses what does it mean if you cannot get above it?

Answer 3

Inguinal hernia or hydrocele

Question 4

In the scrotal masses what does it mean if the mass is separate from the testis and cystic?

Answer 4

epididymal cyst

Question 5

In the scrotal masses what does it mean if the mass is separate from the testis and solid?

Answer 5

epididymitis/orchitis/varicolele

Question 6

In the scrotal masses what does it mean if the mass is testicular and cystic?

Answer 6

hydrocele

Question 7

In the scrotal masses what does it mean if the mass is testicular and solid?

Answer 7

tumor, orchitis, haematocele

Question 8

What are the features of epididymal cysts?

Answer 8

develop in adulthood
separate from testis and cystic
can be spermatocele
only remove if symptomatic

Question 9

What is a hydrocele?

Answer 9

fluid within the tunica vaginalis

Question 10

How can a hydrocele be treated?

Answer 10

watch and wait
aspiration
plication of tunica vaginalis (Lords procedure)

Question 11

How do you diagnose scrotal masses?

Answer 11

USS

Question 12

What is the most common cause of epididymitis and orchitis?

Answer 12

chamlydia

Question 13

What are the features of epididymitis and orchitis?

Answer 13

sudden onset, assoc. fever

Question 14

How should orchitis be treated in patients under 35 years old?

Answer 14

Doxycyclin to cover chlamydia`

Question 15

What is a varicocele?

Answer 15

dilitation of the pampiniform plexus.

Question 16

What are the features of a varicocele?

Answer 16

visible distended blood vessels in scrotum, dull ache,

Question 17

What is a haematocele/

Answer 17

Blood in the tunica vaginalis

Question 18

What are the commonest malignancies of the testis?

Answer 18

seminoma
teratoma
tumors of sertoli or leydig cells

Question 19

How does testicular cancer present?

Answer 19

painless testicular lump, haematospermia, mets of lung

Question 20

What are the risk factors for getting a testicular tumour?

Answer 20

male aged 15-44
undecended testicals
infant hernia

Question 21

How would you test a testicular tumour?

Answer 21

biopsy,
CT,
blood for alphafetoprotein, B humanchorionic gonadotrophin

Question 22

How is testicular cancer treated?

Answer 22

orchidectomy
radio
chemo

Question 23

What are the symptoms of testicular torsion?

Answer 23

sudden onset of pain in one testis,
uncomfortable walking
pain in abdo, nausea and vomiting

Question 24

what are the signs of testicular torsion?

Answer 24

red hot swollen testis

Question 25

How would you test for testicular torsin?

Answer 25

if in any doubt straight to surgery

Doppler USS

Question 26

How do you treat testicular torsion?

Answer 26

gain consent for an orchidectomy then proceed to fo a bilateral fixation.

Question 27

What is prehn’s sign and what does it mean?

Answer 27

Pain diminishes from testis on lifting, positive is indicitve of torsion