Testicular problems Flashcards
Most useful investigation
US
Varicoele - definition
Varicose veins of the testis
Young man wakes up in the middle of the night with extreme sudden onset testicular pain. What is the diagnosis?
Torsion of spermatic cord
Torsion of spermatic cord - who gets it ?
Adolescents
Torsion of spermatic cord - investigation
US
Torsion of spermatic cord - management
Fixation with non absorbable sutures
Must also fix the unaffected side
Torsion of spermatic cord - management if testis is necrotic
Remove it
Blue dot sign on testis indicates what diagnosis?
Torsion of appendix testis
Epididymo orchitis - definition
Inflammation of the epididymis and/or testis
Epididymo-orchitis - cause
Infection
Epididymo-orchitis - management
Analgesia
Ofloxacin for 14 days (this is a quinolone)
Paraphimosis
tight foreskin
- often happens after the foreskin has been retracted nd is not replaced in its natural position
Priapism
Prolonged erection for over 4 hours in the absence of sexual stimulation
Low flow priapism
Venous
Ischaemic
Vascular stasis in the penis and decreased venous outflow
Low flow priapism - investigations
aspirate blood
- dark, low O2, high CO2
US
Low flow priapism - management
Aspiration +/- irrigation with saline
Inject alpha agonist (constriction)
Surgical shunt
Penile prosthesis may be needed
High flow priapism
Arterial
Non-ischaemic
Traumatic disruption
High flow priapism - investigations
Aspirate blood
- normal
US
High flow priapism - management
Most resolve spontaneously
Arterial embolisation
Fournier’s gangrene
A form of necrotising fasciitis occurring in the male genetalia
Fournier’s gangrene - investigations
X-ray or US
- may show gas in tissues (crepitus)
Fournier’s gangrene - management
Surgical debridement
Antibiotics
