systems path 2 exam 3 - scrotum, testes and epididymis (pg 18-32)

causes of scrotum inflammation

fungal infection or dermatoses

MC scrotum neoplasia

SCC

increased serous fluid in tunica vaginalis caused by infection, tumor or idiopathic

hydrocele

what is the MC cause of scrotal enlargement ?

hydrocele

Dx for Hydrocele

transillumination

blood in the scrotum

hematocele

lymph and fatty acids in scrotum

chylocele

underlying condition causing chylocele

filariasis

signs/symptoms of chylocele

fever, chills, HA, skin lesions

what happens if chylocele is left untreated?

gross enlargement of limbs and genitals

causes of filariasis

Wuchereria bancrofti

Filariasis vector

mosquito, flies, arthropods

failure of testicle to descend which is MC idiopathic

cryptorchidism

when is cryptorchidism usually diagnosed?

1-year

cryptorchidism is associated with what?

congenital inguinal hernias (high scrotal MC)

if cryptorchidism persists beyond 5-years, what are some risks?

atrophy and sterility

cryptorchidism increases risk for....

testicular CA (3-5x)

causes of testicular atrophy (cryptorchidism)

ischemia, trauma, increased estrogen, irradiation, chemo

what does testicular atrophy cause?

infertility or sterility

inflammation of testes

orchitis

causes of orchitis

mumps (viral), epididymitis (bacterial)

inflammation of the epididymis

epididymitis

what does orchitis or epididymitis usually begin as?

UTI

infectious causes of orchitis and epididymitis

STD, mumps, TB, autoimmune

spermatic cord twisting

torsion

what does testicular torsion obstruct?

venous drainage and arterial blood supply

signs/symptoms of testicular torsion

obstruction, acute engorgement, pain

when does testicular torsion become a urologic emergency?

~6 hours

Neonatal testicular torsion

Extravaginal testicular torsion, infarcted (no anatomical defect)

Adult testicular torsion

bell-clapper deformity, intravaginal torsion

is neonatal or adult testicular torsion MC?

adult

at what ages does adult testicular torsion occur?

12-18 years

Dx for testicular torsion

physical exam, ultrasound

how many testicular torsion cases spontaneously resolve?

1/3

Tx for testicular torsion

surgical repair, 3/4 need orchidectomy (if surgery is delayed 12+ hours)

enlarged pampiniform venous plexus of the scrotum (think varicose vein)

varicocele

varicocele is a common cause of....

infertility (decreased sperm production and quality)

risks for developing varicocele

vascular defects and family history