SCROTOLOGYSCROTOLOGY

LUMPSLUMPS

Testicular cancerTesticular cancer Epididymal cystEpididymal cyst Orchitis/epididymitisOrchitis/epididymitis HydroceleHydrocele VaricoceleVaricocele HerniaHernia Microcalcification of testesMicrocalcification of testes Skin/subcutaneous scrotal lesionsSkin/subcutaneous scrotal lesions Post vasectomy granulomaPost vasectomy granuloma

Testicular CancerTesticular Cancer Painless (not always) discrete hard irregular Painless (not always) discrete hard irregular

swellingswelling Confined to or replacing testisConfined to or replacing testis Germ cell, act quicklyGerm cell, act quickly GP can order AFP, bHCG whilst referringGP can order AFP, bHCG whilst referring UltrasoundUltrasound

Epididymal cystsEpididymal cysts Cystic lump separate from testisCystic lump separate from testis Benign (reassure & avoid operation)Benign (reassure & avoid operation)

Epididymitis / orchitisEpididymitis / orchitis Acute painful swelling, very tender, scrotum Acute painful swelling, very tender, scrotum

hothot UTI associated with Bladder Outflow UTI associated with Bladder Outflow

ObstructionObstruction STDs (Chlamydia)STDs (Chlamydia) Mumps (2-3% infertility rate)Mumps (2-3% infertility rate)

Acute Epididymo - Acute Epididymo - OrchitisOrchitis

Testicular TumourTesticular Tumour

Varicocele Varicocele “A bag of worms”“A bag of worms” Benign condition, rarely associated with renal tumourBenign condition, rarely associated with renal tumour May be associated with infertilityMay be associated with infertility Management depends on symptomatologyManagement depends on symptomatology

ConservativeConservative EmbolisationEmbolisation SurgerySurgery Recurrence rate highRecurrence rate high Monitor in young boys as may affect test. growthMonitor in young boys as may affect test. growth

HydroceleHydrocele “Avocado shaped swelling”“Avocado shaped swelling” Swelling of hemi scrotum, testicle may be impalpable (caution)Swelling of hemi scrotum, testicle may be impalpable (caution) Transilluminates, generally painless, Transilluminates, generally painless, you can get above ityou can get above it Ultrasound to confirm normal testisUltrasound to confirm normal testis

Testicular torsionTesticular torsion “If Suspected, don’t procrastinate”“If Suspected, don’t procrastinate” Emergency exploration within 4 hoursEmergency exploration within 4 hours

LUMPS…LUMPS…

HerniaHernia Microcalcification of testesMicrocalcification of testes

Follow up sometimes neededFollow up sometimes needed Skin/subcutaneous scrotal lesionsSkin/subcutaneous scrotal lesions Post vasectomy granulomaPost vasectomy granuloma

10-15% chronic pain after vasectomy10-15% chronic pain after vasectomy