Varicocele + Hydrocele

Question 1

What is varicocele

Answer 1

Incompetent/absent valves in spermatic vein causing dilated veins in the pampiniform plexus of spermatic cord

Question 2

Which side is most commonly affected + why

Answer 2

LEFT
Left testicular vein drains into left renal vein- angle creates increased pressure and dilation of pampiniform plexus
Right testicular vein drains into IVC so this is not a problem

Question 3

Symptoms

Answer 3

May be asymptomatic
Scrotal swelling
Infertility (most common cause of male infertility)

Question 4

Sign of varicocele on palpation

Answer 4

Feels like a bag of worms within spermatic cord

Question 5

What is hydrocele

Answer 5

Fluid in tunica vaginalis

Question 6

What age group is hydrocele most common in

Answer 6

Newborns- resolves after 1-2 years

Question 7

What congenital abnormality causes primary hydrocele

Answer 7

patent process vaginalis

Question 8

What can cause secondary hydrocele

Answer 8

Testicular tumour
Trauma
Infection

Question 9

Is the swelling in hydrocele transilluminate

Answer 9

yes

Question 10

If you cannot palpate the testes or the patient is 20-40 years old what should you do

Answer 10

Urgent USS

Question 11

When should infants be referred

Answer 11

If hydrocele fluctuates in size
Cannot be distinguished from inguinal hernia
Localised to spermatic cord
Palpable abdominal mass
If still present by 2 years old

Question 12

Surgical procedures

Answer 12

Lords repair

Jaboulays repair

Question 13

When is aspiration indicated

Answer 13

Symptomatic relief in elderly man who is unfit for surgery