Flashcards in Testis & Scrotum Disorders Deck (68)
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1
Define Cryptorchidism
Undescended testes or absent testes (agenesis)
2
Pathology of Cryptorchidism
Undescended testicles remain in the lower abdomen or at a point of descent into the inguinal canal
Scrotal sac is empty
Spontaneous decent in first 3 months
3
Pathologic Changes to the Undescended Testicle Demonstrated at 6-12 Months
Delay in germ cell development
Changes in spermatic tubules
Reduces number of Leydig cells
Morphologic changes in contralateral descended testicle
4
Consequences of Cryptorchidism
Infertility
Increased risk of malignancy
Indirect inguinal hernias
Increased incidence of testicular torsions
5
Cryptorchidism & Infertility
Increases if disorder is bilateral
Decreased sperm counts
Poorer quality sperm
6
Exam & Diagnosis of Cryptorchidism
Careful exam of genitalia in male infants
Differentiate from retractable testes
Diagosis: ultrasound, laparoscopy
7
Treatment Goals of Cryptorchidism
Enhance future fertility potential
Placement of the gonad in a favorable place for cancer detection
Improved cosmetic appearance
8
Treatment of Cryptorchidism
Orchiopexy after 6 months of life
Lifelong follow-up: infertility & testicular cancer issues
9
Define Hydrocele
Excess fluid collects between the layers of the tunica vaginalis usually peritoneal fluid due to a weakness in the patent processes vaginalis
10
Causes of Hydrocele
Primary congenital defect
Secondary condition
11
Primary Congenital Defect with a Hydrocele
Associated with indirect inguinal hernia
Persist beyond 2 years: surgical treatment indicated
12
Secondary Causes of Hydrocele
Trauma
Epididymitis
Testicular torsion
Orchitis
Infection
Testicular cancer
Appendiceal torsion
13
Hydrocele on Palpation
Palpated a cystic masses
Can become quite large
Mass can be mistaken for a solid tumor
14
Diagnosis of Hydrocele
Ultrasound
Trans-illuminate
15
Define Trans-illumination
Shining a light through the scrotum for the purposed of visualizing its internal structures
16
Ultrasound in Diagnosis of Hydrocele
Determination of underlying conditions
Evaluate if can not transilluminate
17
Hydrocele in a Young Man
Should be considered cancer until proven otherwise
Careful evaluation needed to exclude cancer or infection
18
Hydrocele in an Adult Male
Relatively benign condition
Often asymptomatic
Feeling of heaviness in scrotum
Pain in the lower back
19
Treatment of Primary Causes of a Hydrocele
If painful or cosmetically undesirable, surgical correction is indicated
Inguinally or transcrotally
20
Treatment of Secondary Causes of a Hydrocele
Treat condition causing hydrocele
If communicating with peritoneal cavity then surgery is necessary to close the defect
21
Define Hematocele
Accumulation of blood in the tunica vaginalis
Can compromise testicle
22
Etiologies of a Hematocele
Abdominal surgical procedure
Scrotal trauma
Bleeding disorder
Testicular tumor
23
Define Spermatocele
Painless, sperm-containing cyst that forms on the epididymis
24
Where is a spermatocele located?
Above & posterior to the testes
Attached to epididymis
25
Define Varicocele
Varicosities of the pampiniform plexus
26
Highest incidence of Varicoceles
15-35 years old
Rare before puberty
27
Which side are varicoceles more common?
Left due to left gonadal vein inserts into the left renal vein
28
Symptoms of Varicocele
Asymptomatic
Dull aching
Atrophy
Infertility
Abnormal feeling of heaviness in the left when standing and relieved when recombent
29
Diagnosis of Varicocele
Exam with patient in standing & recumbent position
Disappears in supine position
Feels like "a bag of worms"
30