(U)- Scrotal Lumps Flashcards

1
Q

What are the key causes of scrotal lumps?

A

Hydrocele
Varicocele
Epididymal cyst
Testicular cancer
Epididymo-orchitis
Inguinal hernia
Testicular torsion

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2
Q

What is a hydrocele?

A

Collection of serous fluid within the cavity layer of the tunica vaginalis

Painless
Soft-scrotal swelling

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3
Q

During foetal development how does the tunica vaginalis form?

A

Part of the peritoneal membrane, it becomes separated and remains in the scrotum partially covering each testicle

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4
Q

What are the examination findings of a hydrocele?

A

Palpable testicle within the hydrocele

Soft, fluctuant and large

Irreducible

Transilluminates

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5
Q

Why may you listen to a suspected hydrocele?

A

No bowel sounds, helps to distinguish from a hernia

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6
Q

Hydroceles are idiopathic but can be secondary to what?

A

Testicular cancer

Testicular torsion

Epididymo-orchitis

Trauma

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7
Q

How does a varicocele lead to impaired fertility?

A

Disrupts the temperature in the affected testicle

Testicular atrophy, leading to reduced size and function

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8
Q

Why do most varicoceles occur on the left?

A

Left testicular vein is more vertical

Nutcracker effect of the left renal vein between the aorta and IMA

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9
Q

What can left-sided varicoceles also indicate?

A

Testicular vein obstruction due to renal cell carcinoma

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10
Q

How do varicoceles present?

A

Throbbing/dull pain, worse on standing

Dragging sensation

Sub-fertility or infertility

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11
Q

What are the examination findings of a varicocele?

A

Scrotal mass “bag of worms”

More prominent on standing

Disappears when laying down

Asymmetrical testicular size if varicocele has affected testicular growth

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12
Q

Why is it concerning if a varicocele does not disappear when laying down?

A

May be due to retroperitoneal tumours obstructing drainage of the renal vein

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13
Q

What investigations should be used for varicoceles?

A

Duplex

Semen analysis (fertility concern)

Hormonal tests

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14
Q

What is the difference between an epididymal cyst and a spermatocele?

A

Epididymal cyst
Fluid-filled sac at head of the epididymis

Spermatocele
Epididymal cyst that contains sperm

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15
Q

What are the examination findings of an epididymal cyst?

A

Soft, round lump

Typically at the top of the testicle

Associated with epididymis

Separate from testicle

May be able to transilluminate large cysts

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16
Q

When does an epididymal cyst cause pain?

A

Rare instances where there is torsion causing acute pain and swelling