Friday 9 November 2012

Pain/lumps in the scrotum

Seminoma

  • Seminoma usually presents between the age of 30 to 40 years whereas teratoma commonly presents earlier (20-30 years). Undescended testes are an important risk factor for testicular tumours

Torsion of the testes
  • Congenital abnormality ('bell clapper deformity') that allows torsion of the whole testicle
  • Normally, it is fixed within the tunica vaginalis
  • Pain of torsion is severe and often associated with nausea and vomiting
  • History of trauma (but doesn't need history of trauma)
  • Acute epididymo-orchitis similar presentation
  • Explore surgically to rule out torsion if there is any doubt

Hydrocoele
  • Fluid of hydrocoele surrounds body of testis, and therefore underlying testis is impalpable
  • Primary hydrocoele is idiopathic
  • Secondary hydrocoele is secondary to trauma, tumour, or infection
  • Epididymal cyst is separate from the testis and therefore the testis is impalpable

Acute epididymo-orchitis
  • UTI symptoms such as Frequency and Dysuria
  • Unprotected sexual intercourse
  • Similar to torsion of the testes

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