Scrotal Swelling By Mahmoud Abdelaty.pptx

Scrotal Swellings

1. Scrotal Swelling

2. It is a sac-like structure that contains the testicles, epididymis, and the lower part of the spermatic cord. Plays a critical role in temperature regulation for optimal sperm production.

3. Hydrocele Inguinal hernia Varicocele Spermatocele Testicular tumors

4. It is abnormal fluid collection between the two layers of the processus vaginalis at the inguinoscrotal region related to the testis and/or the spermatic cord. Types: Communicating Non communicating Hydrocele of the cord Vaginal hydrocele Hydrocele of hernial sac

5. Congenital type. There is a communication between its sac and the peritoneal cavity. Slowly evacuates and refills. The only type of hydrocele that shows variation in size.

6. Infantile type. Simulates the congenital type without communication with the peritoneal cavity, so, no variation in size.

7. The unobliterated part of the processus vaginalis is isolated from both the peritoneal sac and the testis. It may be scrotal, inguinal or inguinoscrotal. The testis is not involved in the swelling.

8. Pure scrotal swelling surrounding the testis. Primary (with no detectable cause) or secondary (due to Epididymo-orchitis, testicular tumor and inguinal hernia repair).

9. It is primarily an inguinal swelling (outside the cord) due to fluid accumulation in a closed hernial sac without any other content.

10. Pinching of the parietal layer of tunica vaginalis In minimal vaginal hydrocele. Trans-illumination Test: Positive due to the clear nature of the fluid. In pyocele, hematocele or chylocele, trans-illumination is negative.

11. Trans-illumination Test

12. Scrotal Ultrasonography: It is mandatory when the testis cannot be clinically evaluated to exclude testicular malignancy or atrophy. Special Tests

13. It may be congenital (with patent processus vaginalis and the testis is one of the contents) or acquired (with a new peritoneal hernia sac and the testis is outside). If uncomplicated it shows characteristic signs: expansile impulse on cough and reducibility. It may be complicated by irreducibility, obstruction or strangulation,

14. It is an inguinoscrotal diffuse compressible cord swelling. Its size increases with straining and decreases in supine position. May present with subfertility or dragging scrotal pain. It is usually left sided and may be bilateral.

15. It is an epididymal cyst with unclear fluid containing sperms. It varies in size and sometimes it resembles a third testis.

16. It is usually a painless firm testicular swelling with loss of the characteristic testicular sensation. It may be associated with rapidly formed vaginal hydrocele.

17. Thanks