Urology

Question 1

define testicular torsion

Answer 1

ill-attached tissues of the testicles twist around the spermatic cord causing restriction of blood flow

Question 2

clinical features of testicular torsion

Answer 2

sudden onset severe unilateral testicular pain
can follow minor trauma
high riding scrotum 
absence of cremaster reflex
no relief on testicle elevation
nausea and vomiting

Question 3

management of testicular torsion

Answer 3

expedited surgical exploration with fixation via orchioplexy

Question 4

indications of torsion of epididymal appendage

Answer 4

less pain than torsion

appearance of tiny blue nodule (blue dot sign)

Question 5

complications of testicular torsion

Answer 5

testicular infarction
infertility
cosmetic issues/psychological distress
recurrence of torsion

Question 6

define phimosis

Answer 6

tightness of the foreskin causing non-retractability over the glans

Question 7

define balanitis xerotica obliterans

Answer 7

recurrent balantitis that leads to scarring of the foreskin + glans leading to phemosis

Question 8

treatment of phemosis

Answer 8

potent steroid creams

circumcision

Question 9

clinical features of phimosis

Answer 9

non-retractable foreskin

pinhole meatus

Question 10

define hydrocele

Answer 10

a collection of fluid surrounding the testis

Question 11

clinical features of hydroceles

Answer 11

soft + non-tender scrotal swelling
bluish in appearance
trans-illuminates

Question 12

investigations of hydrocele

Answer 12

US scan - shows simple fluid accumulation

Question 13

management of hydroceles

Answer 13

spontaneously resolve after 1yr

if not resolved by 1yr:
surgical correction

Question 14

complications of hydroceles

Answer 14

inguinal hernia

Question 15

define undescended testes (cryptorchidism)

Answer 15

testes that have not made it out of the abdomen at birth

Question 16

risk factors of undescended testes

Answer 16

FH of undescended testes
low birth weight 
small for gestational age 
prematurity 
maternal smoking in pregnancy

Question 17

management of undescended testes (bilateral at birth)

Answer 17

refer to paediatrics for endocrine and genetic investigations

watchful waiting until 6mnths of age and then orchidoplexy

Question 18

management of undescended testes (unilateral at birth)

Answer 18

review at 6-8wks then watchful waiting until 6mnths

after 6mnths, refer to surgery for orchidoplexy

Question 19

complications of undescended testes

Answer 19

ascending testes

testicular tumour