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SUMMARY OF
INDEX
TESTICULAR NEOPLASM
TESTICULAR CYSTS
EPIDIDYMO-ORCHITIS
TORSION TESTIS
UNDESCENDED TESTIS
VARICOCELE
Painless scrotal swelling Mother complains that her Painless scrotal swelling.
Painless scrotal swelling
C/P Painless scrotal swelling. but sometimes v. large ® infant has scrotal swelling 1) Infection ® pyocele. Calcification – Rupture.
at the spermatic cord 2) Hge ® hematocele.
mistaken for 3rd testis. with Diurnal variation. Herniation through ! dartos ms.
SITE · Just above & behind ! testis. · Just above! testis. · Above the Sp. cord · Abd. exam. ® ± TB · Scrotal neck test = purly scrotal swelling.
· Multilocular + crystal clear fluid · Unilocular – smooth. separated by Gap. st
peritonitis is the 1 manifest · Scrotal US if testis is impalpable.
SP. · Brilliant translucent with Dimly Translucent · Translucent, moves · Fills gradually on standing · Moves from side to side
CCC. numerous septa & tessellated (Barley water in app. from side to side not & empties on lying down not along the cord.
® Chinese lantern app. dt sperms) along the cord. & elevating the scrotum.
CONSIST · Tense cystic. (not lax) · Tense cystic. · Cystic. · Cystic Translucent with
· +ve Traction. (fixed) bi-polar fluctuation test & dull percussion.
TTT. 1) No TTT. is required. 1) Small ® ignore. Excision through an Upper part ® Excision. Surgical & NEVER Aspiration dt:
inguinal incision. a) Recurrence. / inf. / hge.
2) Excision if discomfort but the 2) Large ® Excision Lower part ® Eversion.
pt. should be warned that it but the pt. should be b) If testicular tumor ® implantation.
would interfere with the warned. 1) EVERSION OF TV. (any fluid formed will be
transport of sperms from testis. drained by the scrotal lymphatic)
2) SUB-TOTAL EXCISION OF TV ® if large,
thick walled or calcified.
3) LORDS’ ® incision & plication of TV.
DD 1) Spermtocele / Epidermal Cyst. hydrocele of ! hernial sac. Infantile hydrocele 2ry Vaginal hydrocele
2) Encysted hydrocele of SC. 3
3) Vaginal hydrocele.
INCIDENCE:
Bilateral cases Unilateral cases Symptoms & Signs Complications = 4T
1) Rt. testis = 50%
2) Lt. testis = 30%. dt hormonal defect Empty scrotal compart. + 1) Tumor.
& ass. with hypo-
dt Anatomical barrier
3) Bilateral = 20%. Not well developed + Testis is
gonadism & slipped 1) Short testicualr a. ü 2) Trauma. (abnorm. site)
SITE OF ARREST (acc. to freq.): upper epiphysis 1) Palpated if arrested at ext. 3) Tortion.
2) Ass. hernial sac. ring or neck of scrotum.
1) External ring. 4) aTrophy ® loss of
3) Inadeq. inguinal canal. 2) Impalpable if intrta-abd.
2) Scrotal neck. Spermatogensis sparing
4) Rtetro-perit. adhesiins. 3) diif. to plapate in ing. canal. intrstitial cells ® (N) 2ry
3) Inguinal canal.
5) Rupture gubernaculum. 4) Cong. hernia in 80-90% sex ccc. & erection.
4) Abdominal.
Inguinal Abdominal
after max. mobilization, · Division of the Testicular a. Straining ®Testis more apparent Less apparent
Testsis anchored with (but the A. of vas should be intact) Division & Reanast. Testis can be pushed medially The reverse.
prolene suture & 2nd · Known by clamping the test. a. for of test. a. with Inf.
stage is done after 6 several mins. ® if the testis didn't epigastric a. Open Orchipexy as the testicular See above
ms. become ischemic ® Artery is divide. vs. & vas are of optimal length. 7
It is varicosity (Dilatation, Elongation & torsiousity)
of pampiniform & cremasteric plexus of veins
1RY 2RY