Urology: Testicular Lumps Flashcards
What are the causes of a testicular lump?
Varicocele = swollen veins
Cyst
Cancer = typically unilateral
Hydrocele = fluid in the tunica vaginalis
Haematocele = blood in the tunica vaginalis
Spermatocele = fluid filled sac in the scrotum
Epididymitis = chlamydia, e.coli, mumps, gonorrhoea
Orchitis = chlamydia, e.coli, mumps, gonorrhoea
Indirect inguinal hernia
What are the symptoms of a testicular lump
An unusual lump
Sudden pain
A dull aching pain or feeling of heaviness in the scrotum
Pain that radiates throughout the groin, abdo or lower back
Tender, swollen, hardened testicle/epididymis (above and behind, stores and transports sperm)
Swelling in the scrotum
Redness of the skin of the scrotum
Nausea or vomiting
What investigations should be performed for a testicular lump?
Exam = can you get above it? Is it separate from the testis? Cystic or solid?
- Cannot get above = inguinal scrotal hernia or hydrocele extending proximally
- Separate and cystic = epididymal cyst
- Separate and solid = epididymitis, varicocele
- Testicular and cystic = hydrocele
- Testicular and solid = tumour, haematocele, orchitis
Transillumination
US
Urine test = infection
Blood test = infection, cancer
How is a testicular lump managed?
Infection = Abx
Benign mass = left untreated or surgically removed, repaired, or drained
Cancer = orchiectomy, chemotherapy
What are the possible complications of a testicular lump?
Delayed or poor development during puberty
Infertility
