Urinary tract pathology

Question 1

Function of the testicle

Answer 1

• Sperm production: FSH stimulation

- Androgen production: LH stimulation

Question 2

Route of sperm flow

Answer 2

Seminiferous tubulus –> epididymis –> vas deferens –> ejaculatory duct –> urethra

Question 3

Which cancer has the best 10-year survival rate?

Answer 3

Testicular cancer

Question 4

Risk factors for testicular cancer

Answer 4

1. White caucasian
2. Undescended testes
3. HIV
4. Family Hx

Question 5

What is testicular torsion? Classification, presentation & treatment

Answer 5

When the testicle is twisted upon its own axis, to a point where blood supply to the testicle is occluded, rendering the testicle ischaemic

• Classification:
  1. Extravaginal torsion: most common in infants, when the gubernaculum tissue, which is responsible for bringing the testicle down into the scrotum during embryological development, is not well developed, so the testes are prone to twisting

2. Intravaginal torsion: most common form. In both adults and children. Usually due to a bell clapper deformity, when the testicle lies horizontally as a result of where the vessels insert into the testicle, leaving them prone to twisting
   - Presentation: excruciating pain, with vomiting
   - Treatment: Urgent surgical de-torsion. If left untreated for >24hrs, can lead to a dead, non-viable testicle