Station 11

Question 1

50M Testicular Swelling
History

Answer 1

Focused History:
Duration, Size - incl. change,
Associated symptoms - pain, fevers, uti
Lower urinary tract symptoms
Prev epidydmo orchitis, testicular tumour, trauma,

Previous scrotal/inguinal/abdominal surgery

PMH
DH - allergies/anticoagulants

Question 2

50M Testicular Swelling
Examination

Answer 2

Chaperone
Abdomen - Hernial orifices, Groin Swellings, Abdominal masses

Testicles:
Examine both - normal first
Size lie and texture of both testis
Mass - can you get above? Tender? transilluminuate? Tethetered to skin? cord?

Question 3

Investigations

Answer 3

Urinalysis
Bloods - FBC, U+E, CRP, Consider Tumour Markers
Ultrasound Testes
Consider FR + PVR if worried about BG LUTS
Consider STI Screen

Question 4

management options for hydrocele

Answer 4

Conservative
Aspiration (If unfit. High chance of recurrence and infections)
Surgical - Jaboulay, Lord’s
Sclerotherapy (Unfit. USe sodium tetradecyl sulphate, tetracycline or or doxycline. High risk of recurrence, infertility due to epidydmal obstruction)