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Renal > Penis and testicles > Flashcards

Penis and testicles Flashcards

1
Q

What is balanitis? When is it seen most commonly?

A

Acute inflammation of glans and foreskin
Associated with strep and staph infections
More common in diabetics
Often seen in young children with tight foreskin

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2
Q

Treatment of balanitis?

A

Antibiotics, circumcision and hygiene advice

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3
Q

What is phimosis?

A

Occlusion of the meatus by the foreskin
In young boys this causes balanitis and ballooning
In adults - painful sex, infection and ulceration

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4
Q

What is paraphimosis?

A

Occurs when tight foreskin is retracted and becomes irreplaceable
Impairs venous return - leading to oedema and ischaemia of glans

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5
Q

Treatment of paraphimosis

A

Ask patient to squeeze glans
Apply a glucose-soaked swab - oedema may follow osmotic gradient
Ice packs and lidocaine gel
May require aspiration, dorsal slit or circumcision

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6
Q

Features of acute prostatitis?

A 
UTIs
Retention 
Pain 
Haematospermia 
Swollen/boggy prostate on DRE
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7
Q

Treatment of acute prostatitis?

A

Levofloxacin and analgesia

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8
Q

Features of chronic prostatitis?

A 
Those of acute but present for >3months
UTI
Retention 
Pain 
Haematospermia
Swollen/boggy prostate on DRE
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9
Q

Lump in testicle

A

Cancer until proven otherwise

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10
Q

Acute, tender enlargement of testicles

A

Torsion until proven otherwise

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11
Q

Can you get above the scrotal mass?

A

If you can’t - inguinoscrotal hernia or hydrocele extending proximally

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12
Q

Scrotal mass separate from the testis and cystic

A

Epididymal cyst

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13
Q

Scrotal mass separate from the testis and hard

A

Epididymitis or varicocele

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14
Q

Scrotal mass which is testicular and cystic

A

Hydrocele

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15
Q

Scrotal mass which is testicular and solid

A 
Tumour
Haematocele 
Granuloma 
Orchitis 
Gumma
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16
Q

What are epididymal cysts?

A

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

Feel separate and cystic

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17
Q

What are hydroceles?

A

Fluid within tunica vaginalis

Feel testicular and solid

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18
Q

Two types of hydrocele

A

Primary is associated with patent processus vaginalis - more common - larger and usually in younger men - can resolve spontaneously
Secondary to testis tumour/trauma/infection

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19
Q

Treatment of hydrocele

A

Drainage - aspiration
May need repeating
Surgery - plicating tunica vaginalis

20
Q

What is epididymo-orchitis?

A

Infection of testes and epididymus

21
Q

Causes of epididymo-orchitis?

A

Chlamydia, e.coli, mumps, gonorrhoea, TB

22
Q

Features of epididymo-orchitis?

A

Sudden-onset tender swelling
Dysuria
Sweats and fever

23
Q

Treatment of epididymo-orchitis?

A

Doxycycline - covers chlamydia
Ceftriaxone if gonorrhoea suspected
For 2-4 weeks

24
Q

What is varicocele?

A

Dilated veins of the pampiniform plexus

Left sided more commonly affected

25
Q

Presentation of varicocele

A

Often visible as distended scrotal blood vessels that feel like a “bag of worms”
May complain of dull ache
Associated with subfertility
Separate and solid - examination

26
Q

What is haematocele

A

Bleeding in tunica vaginalis following trauma
May need drainage/excision

Feels testicular and solid

27
Q

Incidence of testicular tumours

A

Most common malignancy in men aged 15-44

10% occur in undescended testis, even after orchidopexy

28
Q

Incidence of contralateral testicular tumour

A

5%

29
Q

Signs of testicular tumour

A

Painless lump - found after trauma/infection (when feel for it)
Can also get
haematospermia, secondary hydrocele, pain
Lung mets - dyspnoea

30
Q

Risk factors for testicular tumour

A

Undescended testis
Infant hernia
Infertility

31
Q

Staging of testicular tumour

A

1) No evidence of mets
2) Infradiaphragmatic node involvement - spread via para-aortic
3) Supradiaphragmatic node involvement
4) Lung involvement - haematogenic spread

32
Q

Tumour markers in testicular tumour

A

Alpha-fp

Beta-hCG

33
Q

Treatment of testicular tumour

A

Radical orchidetomy
Radiotherapy post-op
Do close follow up

34
Q

Treatment of non-seminomatous germ cell tumour (335)

A

Bleomycin, etoposide and cisplatin

35
Q

Surgery and salvage rate in torsed testicle

A

If 24 hrs then 0-10%

36
Q

Symptoms of torsed testicle

A

Rapid onset of pain in one testis
Makes walking uncomfortable
Pain in abdomen, nausea and vomiting

37
Q

Signs of torsed testicle

A

Inflammation of one testis - tender, hot and swollen

May lie high and transversely

38
Q

When is testicule torsion most common

A

age 11-30

39
Q

Treatment of torsed testicle

A

Possible orchidectomy - ask consent
Bilateral fixation - untwist testis
If colour looks good - return to scrotum and fix both

40
Q

What is epididymal appendage?

A

Occurs 7-12
Less pain than torsion
Tiny blue nodule under scrotum

41
Q

Incidence of undescended testis

A

3% - 30% if premature

Uni:bilateral = 4:1

42
Q

What is cryptorchidism?

A

Complete absence of testis from scrotum

43
Q

What is anorchism?

A

Absence of both testis from scrotum

44
Q

What is retracile testis?

A

Excessive cremasteric reflex - testicle found at external inguinal ring

45
Q

Maldescended testes

A

Found anywhere from abdomen to groin

46
Q

Complications of undescended testis

A 
Infertility
x40 increased risk of testicular cancer - in cryptorchidism may be decreased if surgery performed before age 10
Testicular torsion 
Hernias 
Other UT abnormalities
47
Q

Treatment of maldescended and ectopic testis

A

Restores spermatogenesis

Orchidopexy - brought down into scrotum

Renal (9 decks)

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