FN: Lumps in the groin and scrotum Flashcards Preview

Final Notes > FN: Lumps in the groin and scrotum > Flashcards

Flashcards in FN: Lumps in the groin and scrotum Deck (27):
1

Differential

Cant get above:
Seperate cystic
Seperate solid
testicular cystic
Testicular solid

2

Cant get above

Inguinal hernia

3

Seperate cystic

Epididymal cysts

4

Seperate solid

Varicolcoela, sperm granuloma,, epididymitis

5

testicular cystic

Hydrocoele

6

Testicular solid

tumour, orchitis, haematocele

7

Epididymal cyst

- develop in adulthood
- Contain clear or milky (spermatocele) fluid
- Lie above and behind testis
- Remove if symptomatic

8

Varicocele

- Dilated veins of pampiniform plexus

9

Varicocele presentation

- feel like bag f worms in the scrotum
- may be visinle dilated veins
- reduced size on lying down
- pt. may c/o dull ache
- may - oligospermia (reduced fertility)

10

Varicocele pathology

primary: left side commoner: drain into left renal vein
Secondary: left renal tumour has tracked down renal vein - testicular vein obstruction

11

Varicocele Mx

Conservative: scrotal support
Surgical: clipping the testicular vein (open or laP)

12

Sperm granuloma

Painful lump of extravasated sperm after vasectomy

13

Hydrocele

Collection of serous fluid w/i tunica vaginalis

14

Hydrocele primary

Association with patent processus vaginalis
Commoner, large, tense, younger men

15

Hydrocele secondary

Tumour, trauma, infection
Smaller, less tense

16

Hydrocele investigation

US testicle to exclude tumour

17

Hydrocele Mx

May resolve spontaneously
Surgery:
Aspiration

18

Surgery Lords repair

Plication of the sac

19

Surgery jaboulays repair

Eversion of the sac

20

Aspiration

Usually recur so not 1st line
Send fluid for cytology and MC+S

21

Haematocele

Blood in the tunica vaginalis
Hx of trauma
May need drainage or excisions

22

Epididymo-Orchitis aetiology

STI: chlamdia, gonorrhoea
Ascending UTI: e.coli
Mumps

23

Epididymo-Orchitis features

Sudden onset tender swelling
Sweats, fever

24

Epididymo-Orchitis examination

Tender, red, warm, swollen testis and epididymis - elevating testicle may relieve pain

Secondary hydrocele
Urethral discharge

25

Epididymo-Orchitis Investigation

Blood: FBC, CRP
Urine : dip, MC+S (fist catch may be test)
Urethral swab and STI screen
US: may be needed to exclude abcess

26

Epididymo-Orchitis complications

May - infertility

27

Epididymo-Orchitis Management

bed rest
Analgesia
Scrotal supportabx: doxycycline or cipro
Drain abcess if present

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