Testicular Lump Flashcards
What are the differentials of a testicular lump?
Varicocoele. Hydrocoele. Haematocoele. Testicular tumour. Epididymal cyst. Orchitis.
What is a varicocoele?
Dilated veins of the pampiniform plexus.
Which side is a varicocoele most commonly found?
Left.
On palpation, what would a varicocoele feel like?
A bag of worms.
Is a varicocoele visible?
Yes.
What symptom/s does a varicocoele produce?
Dull ache.
What is a hydrocoele and what is it due to?
Fluid within the tunica vaginalis due to a patent processus vaginalis or secondary to trauma/infection. Can resolve or may need aspirating.
What is a haematocoele and what is it due to?
Blood within the tunica vaginalis following trauma.
What is an epididymal cyst?
Lump lying above and behind testes containing clear or milky fluid.
What is orchitis caused by?
Caused by chlamydia, gonorrhoea, E.Coli and TB.
What are the symptoms of orchitis?
Sudden onset tender swelling with dysuria.
How is orchitis managed?
STI screen and give Abx.
What should be assess on examination of a testicular lump?
Can you get above it? – If NOT = inguinoscrotal hernia or hydrocoele extending proximally.
Is it separate from the testes? – SOLID = Epididymitis or varicocoele. CYSTIC = Epididymal cyst.
Is it attached to the testes? – SOLID = Tumour, haematocoele, orchitis. CYSTIC = Hydrocoele.
What is the first line investigation for a testicular lump and why?
USS, to distinguish whether the mass is directly from the testes or an intrascrotal swelling.
What blood markers are raised in testicular tumours?
B-HCG, AFP and LDH can all be raised.
