Scrotal and Testicular Disorders Flashcards Preview

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Flashcards in Scrotal and Testicular Disorders Deck (43)
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1

Undescended testes or absent testes (agenesis). Occurs when one or both of the testicles fail to move down into the scrotal sac

Cryptorchidism

2

What is the incidence of cryptorchidism directly related to?

birth weight and gestational age

3

When does spontaneous descent of an undescended testicle usually occur?

during 1st three months, rarely after 6 months

4

Long-term consequences of cryptorchidism

infertility, malignancy, inguinal hernias, testicular torsion

5

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

6

Excess fluid collects between the layers of the tunica vaginalis usually peritoneal fluid due to a weakness in the patent processus vaginalis

hydrocele

7

What are primary congenital hydroceles associated with?

indirect inguinal hernia

8

How long do you wait before doing surgical treatment of a hydrocele?

2 yrs

9

How should you evaluate a suspected hyrocele?

transillumination first. ultrasound if transillumination fails

10

What should a hydrocele in a young man be considered until proven otherwise?

cancer

11

Symptoms associated with a hydrocele

heaviness in the scrotum and pain in the lower back

12

Accumulation of blood in the tunica vaginalis. Can compromise testicle. Causes scrotal skin to become dark red or purple

hematocele

13

Painless, sperm-containing cyst that forms at the end of the epididymis. Located above and posterior to the testes. Attached to the epididymis

spermatocele

14

What is the treatment for a spermatocele if it has become painful?

excision

15

Cause of varicocele that results from damage to the elastic fibers and hypertrophy of vein walls

varicosities of the pampiniform plexus

16

Age group usually affected by varicoceles

15-35 yrs

17

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.

18

Typically disappears in the supine position and feels like a bag of worms on palpations

varicocele

19

What is the surgical treatment for a varicocele in males showing testicular atrophy?

liagation of the gonadal vein

20

Twisting of the testes on the long axis of the tunica vaginalis rotates about the spermatic cord. usually presents before 18yrs. Urological emergency

testicular torsion

21

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

22

Because most torsions twist inward and toward the midline, which way should you twist for manual detorsion?

outward and laterally

23

What STIs are associated with epididymitis?

gonorrhea and chlamydia

24

What bacteria are involved with non-sexually transmitted epididymitis that is associated with UTIs and prostatitis?

e. coli, pseudo, gram (+) cocci

25

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

26

Treatment for epididymitis besides antibiotics

bedrest, scrotal elevation, avoid sexual activity until sx resolve

27

Infection of the testes. Caused by primary infection of the GU tract or infection spread to the testes through the bloodstream or lymphatics

orchitis

28

Systemic source of orchitis that doesn't occur in prepubertal boys, but affects 20-35% of adolescent boys/young men

parotitis (mumps)

29

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

30

What are the potential residual effects of orchitis?

hyalinization of the seminiferous tubules and testicular atrophy