SCROTOLOGY

LUMPSTesticular cancerEpididymal cystOrchitis/epididymitisHydroceleVaricoceleHerniaMicrocalcification of testesSkin/subcutaneous scrotal lesionsPost vasectomy granuloma

Testicular CancerPainless (not always) discrete hard irregular swellingConfined to or replacing testisGerm cell, act quicklyGP can order AFP, bHCG whilst referringUltrasound

Epididymal cystsCystic lump separate from testisBenign (reassure & avoid operation)Epididymitis / orchitisAcute painful swelling, very tender, scrotum hotUTI associated with Bladder Outflow ObstructionSTDs (Chlamydia)Mumps (2-3% infertility rate)

Acute Epididymo - Orchitis

Testicular Tumour

Varicocele A bag of wormsBenign condition, rarely associated with renal tumourMay be associated with infertilityManagement depends on symptomatologyConservativeEmbolisationSurgeryRecurrence rate highMonitor in young boys as may affect test. growth

HydroceleAvocado shaped swellingSwelling of hemi scrotum, testicle may be impalpable (caution)Transilluminates, generally painless, you can get above itUltrasound to confirm normal testis

Testicular torsionIf Suspected, dont procrastinateEmergency exploration within 4 hours

LUMPS

HerniaMicrocalcification of testesFollow up sometimes neededSkin/subcutaneous scrotal lesionsPost vasectomy granuloma10-15% chronic pain after vasectomy