Testicular Swellings

Question 1

What is epididymo-orchitis?

Answer 1

Painful swelling of epididymus and/or testis

Question 2

What is the presentation of epididymo-orchitis?

Answer 2

Gradual onset
+/- urinary symptoms
Swelling/erythema
Induration/tenderness +/- hydrocoele

Question 3

What is the treatment for epididymo-orchitis?

Answer 3

> 35: ciprofloxacin 10-14 days
<35: doxycycline (+/- ciprofloxacin)
NSAIDs
Scrotal support

Question 4

What investigations are done in epididymo-orchitis?

Answer 4

Urinalysis/MSU

Urgent USS if diagnosis unclear or possibility of abscess

Question 5

What is the presentation of testicular torsion?

Answer 5

Sudden acute severe pain
Abdo pain/vomiting
Testis - high riding/transverse lie
Resist examination due to pain

Question 6

What is the management for testicular torsion?

Answer 6

Surgery - salvage within 6-8hrs

Fix other side

Question 7

How is testicular torsion diagnosed?

Answer 7

Clinical diagnosis

Explore if any doubt

Question 8

What is a possible differential of testicular torsion in prepubertal boys?

Answer 8

Torsion of appendix testis / torted hydatid

Question 9

What may distinguish torsion of appendix testis?

Answer 9

Usually cannot distinguish from testicular torsion

Blue dot sign

Question 10

What is the management of torsion of appendix testis?

Answer 10

Manage conservatively - ONLY if confident of diagnosis

Question 11

Give some other causes of testicular swellings

Answer 11

Epididymal cysts
Hydrocele
Varicocele
Inguino-scrotal hernia
Haematoma
Testicular tumours