Scrotal Lump Flashcards Preview

Y3M - Urology > Scrotal Lump > Flashcards

Flashcards in Scrotal Lump Deck (22)
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1

Hx of scrotal lump

Time of onset

Associated symptoms

Previous episodes

2

Examination

 

6S:
Site
Size
Shape
Symmetry
Skin changes
Scars present

When palpating...
CAMPFIRE
Consistency
Attachments
Mobility
Pulsation
Fluctuation
Irreducibility
Regional lymph nodes
Edge

+ Tenderness, temprature and transilluminsation.

Make sure to see if you can separately palpate all structures in scrotum

3

Investigations

1st line is USS of scrotum

Blood tests or further imaging miay be warrante

4

Explain hydrocoele

Abnormal collection of peritoneal fluid between parietal and visceral layers of the tunica vaginalis.

5

Clinilca features of hydrocoele

Painless fluctuatin swelling

Transillumination

Unilateral or bilateral

 

Can happen congenitally

6

Management of congenital hydrocoele

Usually regress spontanesouly by one or two years of age

No treatment is usually needed 

If there is a patent processus vaginalis ligation will be required to stop recurrence

7

Causes of hydrocoele in older men

Primary idiopathic

Secondary due to trauma, infetion or malignancy.

Between 20-40 with presentation should have urgent USS

8

What is varicocoele

Abnormal dilation of the pampiniform venous plexus within the spermatic cord.

9

Clinical features of varicocoele

Lump as a bag of worms or with a dragging sensation.

May disappear on lying flat

Examine lying down and standing up and perform a valsalva manoeuvre

10

Where are most varicocoeles found?

On the left side as it drains into left renal vein instead of IVC as done on the right

11

Complications of varicocoele

Can cause infertility and testicular atrophy by increasing intra-scrotal temperature

Semen analsysis and referral to urology should be done.

12

Red flag signs of varicocoele

Acute onset

Right sided

Remain when lying flat

These should be investigated urgently.

13

Treatment of asymptomatic varicocoeles

No need for tx

14

Treatment of symptomatic varicocoele

Surgical by embolisation by interventional radiologist.

Open or laparoscopic approach for ligation of the spermatic veins.

15

Explain epididymal cysts

Aka spermatocoele

Benign fluid-filled sacs arising from the epididymis

 

16

Clinical features of epididymal cysts

They present as a smooth fluctuant nodule and found above and separate from the testis.

It will transilluminate and are often multiple.

17

When are epididymal cysts seen?

Common pathoogy seen in middle aged men.

18

Treatment of epididymal cysts

Usually doesnt give symptoms and no association of malignancy.

This means that they dont generally need treatment

 

If the yare very large and symptomatic surgery might be required, try to avoid this in younger men as infertility can ensue.

19

Examination of testis of inguinal hernia

You cannot get above an inguinal hernia within the scrotum.

It may disappear upon lying flat

20

Benign testicular lesions

Leydig cell tumours

Sertoli cell tumours

Lipomas

Fibromas

21

Explain orchitis

usually due to mumps.

Rest and analgesia and it should self-limit

Intra-testicular abscess can be the cause which would need drainage and occasionally orchidectomy

22

Way to distinguish between lumps