1. SCROTOLOGY

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

3. 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

4. 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)

5. Acute Epididymo - Orchitis

6. Testicular Tumour

7. 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

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