SCROTOLOGY

LUMPS Testicular cancer Epididymal cyst Orchitis/epididymitis Hydrocele Varicocele Hernia Microcalcification of testes Skin/subcutaneous scrotal lesions Post vasectomy granuloma

Testicular Cancer Painless (not always) discrete hard irregular swelling Confined to or replacing testis Germ cell, act quickly GP can order AFP, bHCG whilst referring Ultrasound

Epididymitis / orchitis Epididymal cysts Cystic lump separate from testis Benign (reassure & avoid operation) Epididymitis / orchitis Acute painful swelling, very tender, scrotum hot UTI associated with Bladder Outflow Obstruction STDs (Chlamydia) Mumps (2-3% infertility rate)

Acute Epididymo - Orchitis

Testicular Tumour

Varicocele “A bag of worms” Benign condition, rarely associated with renal tumour May be associated with infertility Management depends on symptomatology Conservative Embolisation Surgery Recurrence rate high Monitor in young boys as may affect test. growth Hydrocele “Avocado shaped swelling” Swelling of hemi scrotum, testicle may be impalpable (caution) Transilluminates, generally painless, you can get above it Ultrasound to confirm normal testis Testicular torsion “If Suspected, don’t procrastinate” Emergency exploration within 4 hours

LUMPS… Hernia Microcalcification of testes Follow up sometimes needed Skin/subcutaneous scrotal lesions Post vasectomy granuloma 10-15% chronic pain after vasectomy