Testis & Scrotum Disorders Flashcards Preview

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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

Treatment of Varicocele

Surgical ligation of the gonadal vein
Embolization of veins
Obliteration of the dilated veins
NSAIDs
Scrotal support