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Scrotum

Terms in this set (23)

Trauma of the scrotum/rupture
presents challenge b/c scrotum often painful and swollen - trauma may be result of MVA, athletic injury, direct blow to scrotum, or straddle injury - determine if rupture is present - alteration of testicular parenchymal pattern, hematocele, scrotal wall thickening
Epididymitis
may result from trauma; color doppler imaging can be used to identify increased vascularity in your epididymitis
Torsion
Associated with trauma color doppler will show no flow - abnormal mobility "bell-clapper deformity" occurs when tunica vaginalis completely surrounds testis, epididymis, distal spermatic cord, allowing them to move and rotate freely within scrotum - undistended testis 10 times more likely to have more anomaly - most common cause of acute scrotal pain in adolescents - 4-6 hours swollen, hypoechoic
24 hours - heterogenous due to hemorrhage, infarction, necrosis
Hydrocele and Pyocele
Hydro - most common cause of painless scrotal swelling and found around the anterolateral aspect of testis. may appear anechoic or contain low-level echoes- complex hydroceles may be associated with severe epididymitis and orchitis- Pyocele is a puss filled space between layers of tunica vaginalis - pyoceles much less common and occur with untreated infection or when an abscess ruptures into space between layers of tunica vaginalis
Spermatocele
Cystic dilations of efferent ductules of epididymis - always located in epididymal head - contain proteinaceous fluid and spermatozoa - may be seen more often following vasectomy
Epididymal cyst
Clear/small cysts containing serous fluid located within the epididymis, generally asymptomatic but may be palpable
Varicocele
Abnormal dilation of veins of papiniform plexus more common on left - associated with infertility - measure greater than 2 mm in diameter- increases in diameter in response to valsalva maneuver - numerous tortuous tubes
Scrotal hernia
When bowel, omentum, or other structures herniate into scrotum - bowl most commonly herniated structure, followed by omentum
Sperm Granuloma
Chronic inflammatory reaction to extravasation of spermatozoa - most frequently seen in patients with history of vasectomy - can be located anywhere within epididymis or vas deferens - heterogeneous, solid mass: hypoechoic or isioechoic to epididymis
Tubular ectasia of rete testis
Benign/uncommon, a condition associated with presence of a spermatocele, epididymal, or testicular cyst or other epididymal obstruction on same side as dilated tubules - tiny tubular structures near mediastinum, appears as prominent hypoechoic channels near the echogenic mediastinum - Will be avascular - more common in men over the age of 55
Intratesticular cysts
Cysts more common in men over 40 years of age - assocaited with extratesticular spermatoceles - located near mediastinum - single or multiple and variable size
Microlithiasis
microcalcifications are <3mm - usually bilateral - associated with cryptorchidism, klinefelter's syndrome, infertility, variococeles, testicular atrophy, and male pseudohermaphroditism
Germ Cell Tumor
is one of the most curable forms of cancer - undescended testes are 2.5 to 8 times more likely to develop cancer - painless lump, testicular enlargement, or vague - elevated AFP, most common type of germ cell tumor is seminoma, elevated HCG - most common testicular cancer - focal hypoechoic mass
Mets
rare, normally occuring later in life - primary tumor may originate from prostate or kidneys, soldi hypoechoic mass, hyperechoic, mix of both
Lyphoma & Leukemia
1-7 % of all testicular tumors; most most common bilateral secondary testicular neoplasm affecting men > 60 years - Leukemia involvment of testicle is most common secondary testicular neoplasm; most often found in children
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