Flashcards in Scrotal and Testicular Disorders Deck (43)
Undescended testes or absent testes (agenesis). Occurs when one or both of the testicles fail to move down into the scrotal sac
What is the incidence of cryptorchidism directly related to?
birth weight and gestational age
When does spontaneous descent of an undescended testicle usually occur?
during 1st three months, rarely after 6 months
Long-term consequences of cryptorchidism
infertility, malignancy, inguinal hernias, testicular torsion
How do you differentiate between undescended and retractable testes?
retractable are palpable at birth, palpation in warm room can bring them down, and assume scrotal position at puberty
Excess fluid collects between the layers of the tunica vaginalis usually peritoneal fluid due to a weakness in the patent processus vaginalis
What are primary congenital hydroceles associated with?
indirect inguinal hernia
How long do you wait before doing surgical treatment of a hydrocele?
How should you evaluate a suspected hyrocele?
transillumination first. ultrasound if transillumination fails
What should a hydrocele in a young man be considered until proven otherwise?
Symptoms associated with a hydrocele
heaviness in the scrotum and pain in the lower back
Accumulation of blood in the tunica vaginalis. Can compromise testicle. Causes scrotal skin to become dark red or purple
Painless, sperm-containing cyst that forms at the end of the epididymis. Located above and posterior to the testes. Attached to the epididymis
What is the treatment for a spermatocele if it has become painful?
Cause of varicocele that results from damage to the elastic fibers and hypertrophy of vein walls
varicosities of the pampiniform plexus
Age group usually affected by varicoceles
Why are varicoceles more common in the left testicle besides presence of more incompetent valves?
left internal spermatic vein inserts renal vein at right angle and force of gravity from upright position causes venous dilatation.
Typically disappears in the supine position and feels like a bag of worms on palpations
What is the surgical treatment for a varicocele in males showing testicular atrophy?
liagation of the gonadal vein
Twisting of the testes on the long axis of the tunica vaginalis rotates about the spermatic cord. usually presents before 18yrs. Urological emergency
Patient presents with N/V, tachycardia, large/firm/tender testes with pain radiating to inguinal area. cremasteric reflex is absent. what should you order?
Color Doppler ultrasonography and emergent urology referral since this is the presentation for testicular torsion
Because most torsions twist inward and toward the midline, which way should you twist for manual detorsion?
outward and laterally
What STIs are associated with epididymitis?
gonorrhea and chlamydia
What bacteria are involved with non-sexually transmitted epididymitis that is associated with UTIs and prostatitis?
e. coli, pseudo, gram (+) cocci
Patient presents with unilateral pain/swelling of testes. Erythema and edema of scrotal skin, fever, and dysuria. What tests should you order?
CBC, UA w/culture, urethral culture (or NAAT), gram stain. This is presentation for epididymitis
Treatment for epididymitis besides antibiotics
bedrest, scrotal elevation, avoid sexual activity until sx resolve
Infection of the testes. Caused by primary infection of the GU tract or infection spread to the testes through the bloodstream or lymphatics
Systemic source of orchitis that doesn't occur in prepubertal boys, but affects 20-35% of adolescent boys/young men
Patient presents with fever, painfully enlarged testes with small hemorrhages into the tunica abluginia, but no urinary symptoms. What is the best management?
none, course for orchitis is 7-10 days and unpredictable