Testicular lumps

Question 1

What are the common examination findings?

Answer 1

Hydrocele - Enlarged testicle due to fluid SEPERATE that will transillumnate. May make examination of the testicle hard

Varicocele - Feels like a bag of worms and is seperate from the testicle. Can get above it and it isnt transilluminable

Epidydimal cyst - Palpable lump discrete from testes

Epididymitis - Usually tender uniform swelling of epidydmis

Cancer - Palpable lump that is part of testes

Question 2

What are the investigations?

Answer 2

To finish the exam i would like - Full abdo exam including PR and check the groin for hernia and do urinalysis

By the bed - History, obs

Bloods - FBC for infection, U/E for renal function, may want testicular tumour markers

Other - US, refer for surgical input CTKUB if varicocele

Question 3

What are the key investigation findings?

Answer 3

Depends on cause

Question 4

What is the treatment?

Answer 4

Conservative - Explain what the diagnosis is and offer reassurance. Don’t neccasarily do anything for varicoceles, cysts

Medical - Antibiotics if epidydimitis

Surgical - Refer if hydrocele, varicocele, ?tumour, and can do for cysts

Question 5

What are causes of each pathology?

Answer 5

Hydrocele - idiopathic or secondary to another cause

Varicocele - normally idiopathic but can be due to Left renal vein obstruction

Epidydimal cyst - idiopathic

Epididymitis -Usually STDs or UTI