Pathology of Scrotum
"Bear down" as if to have a bowel movement "Flex ab muscles" Dual Screen - Color Doppler Technique
Valsalva Maneuver
Most common form of testicular cancer in children
Yolk Sac tumors
Hematocele
a collection of blood within the scrotum
Monorchia
a condition in which only one testicle is present
Hydrocele
a fluid collection found within the scrotum
pyocele
a pus collection within the scrotum
Testicular Ectopia
a testicle that has taken a non-standard path through the body and ended up in an unusual location
Anorchia
absence of testicular tissue
hematocele
accumulation of blood around the testicles
Almost all prostate cancers are
adenocarcinomas
-History of adrenal hyperplasia -Elevated adrenocorticotropic hormone
adrenal rest
Variocele
an abnormal dilation of the veins of the pampiniform plexus
Hydrocele is most often found
between the layers of the tunica vaginalis
Peyronie Disease
buildup of fibrous plaque and calcification within the penis that results in painful curvature
sonographically this pathology resembles "Swiss cheese"
choriocarcinoma
microlithiasis
condition of small stones within the testes
spermatoceles
cystic dilations of efferent ductules of the epididymis
Adrenal rest
ectopic adrenal tissue caused by the migration of the adrenal tissue with the gonadal tissue during fetal development
Scrotal Pearl
extra-testicular calculus
tunica albuginea cyst
fluid collection within the tunica albuginea
95% of all testicular tumors are _____
germ cell tumors
polyorchidism
having more than two testes
Orchitis
inflammation of one of both testicles
Epididymitis
inflammation of the epididymis and/or testicle from an infection
Prostatitis
inflammation of the prostate gland
Choriocarcinoma sonographic appearance
irregular borders
-Higher risk for malignancies (testicular cancer) -Cryptorchidism -Klinefelter's syndrome - sex chromosome disorder -Infertility -Varicoceles -Testicular atrophy -Male pseudohermaphroditism
microlithiasis
When assessing for possible torsion, be sure to sample blood flow in the _________ of the testicle as well - not just along the periphery
middle
Sperm Granuloma
occurs as chronic inflammatory reaction to extravasation of spermatozoa developing at the site where the bloackage occurs
testicular abscess
occurs due to untreated epididymo-orchitis
testicular torsion
occurs when arterial blood supply is cut off
polyorchidism is most common
on the left side
associated with adrenal hyperplasia or "Cushing's Disease"
Adrenal Rests
-Nocturia -Increased urinary frequency -Sense of urinary urgency -Constant feeling of having a full bladder -Elevated PSA
BPH
May cause testicular infarction
Epididymitis
Most common cause of acute testicular pain for adults
Epididymitis
Pathology of the scrotum most commonly found from UTI or untreated STD
Epididymitis
Associated with elevated levels of hCG and AFP
Germ Cell Tumors
1% - 7% of all testicular tumors, most common bilateral secondary testicular neoplasm affecting men > 60 yo
Lymphoma
Benign Prostatic Hypertrophy (BPH)
Most commonly located within the transitional zone -Age-associated prostate gland enlargement that can cause urination difficulty -This type of prostate enlargement isn't thought to be a precursor to prostate cancer
Bacterial or viral infections can cause
Orchitis
What type of transducer is used during a scrotal examination?
"Hockey Stick" high frequency transducer
Penile trauma
- rupture of the erectile tissue - typically due to incorrect deviation during sexual trauma
Mets to Scrotum
-Rare -Primary tumor: may originate from **prostate or kidneys -less common sites: lung, pancreas, bladder colon, thyroid, or skin
normal scrotal wall measurement
2 and 8mm
Vascular impotence
Caused by vascular compromise to or within the penis that results in the inability to obtain or maintain an erection
Clinical findings of Pyocele
Elevated WBC Painful, swollen scrotum redness and warm to the touch
Second most common malignant neoplasm of the testicle
Embryonal Cell tumor
Elevated PSA Enlarged Prostate Blood in urine or semen Back pain, pelvic pain, thigh or hip pain Impotence Decrease in the amount of ejaculated fluid
Prostate Cancer
Hematospermia - blood in semen Painful ejaculation Perineal pain dysuria
Prostatitis
Rare, said to be either congenital or acquired Usually asymptomatic but can be associated with Zinner syndrome
Seminal Vesicle Cysts
This occurs in patients with a history of vasectomy:
Sperm Granuloma
Associated with extratesticular spermatoceles Located near mediastinum Can be single or multiple and size varies Can be Simple or Epidermoid More common in men over 40
Testicular Cyst
Most common type of benign testicular neoplasm
Testicular Epidermoid Cyst
This benign pathology is also known as keratocysts
Testicular Epidermoid Cyst
-Painful, swollen scrotum -Fever -Leukocytosis
Testicular abscess
Complex intratesticular mass Flow is around but not within the mass Mass that has no flow centrally, but increased flow around its margins May have a coexisting pyocele
Testicular abscess
-Simple cyst noted within testes -Whorled or onion skin appearance
Testicular cyst
This is one of the most urgent types of ultrasound exams! Needs to be preformed ASAP - If not found within 6 hours, it could lead to infertility or loss of testicle
Testicular torsion
acute scrotum
results from a direct blow to the scrotum due to injury
During a sonographic exam for acute scrotum what is the first thing we should look for?
rupture
Acute scrotum is also referred to as
scrotal trauma
Occurs when bowel, omentum or other structures herniate into the scrotum
scrotal/inguinal hernia
Most common malignant neoplasm of the testicle
seminoma
-Acute testicular Pain -Leukocytosis -Fever -Dysuria -Urethral discharge -Scrotal wall edema
signs and symptoms of Epididymitis
epididymal cysts
small clear cysts
This pathology can also look like testicular torsion appendage
sperm granuloma
testicular torsion is also known as
spermatic cord torsion
Acute scrotum clinical findings
swollen or discolored scrotum painful to the touch history of acute injury
Often exists as part of testicular mixed germ cell tumors
teratoma
Seen with a pyocele
testicular abscess
Signs and symptoms of testicular torsion
testicular pain pain in lower abdomen and inguinal region swollen scrotum N/V
Scrotal wall thickening is caused by:
testicular torsion inflammation/infection trauma Idiopathic - unknown cause
Cryptorchidism
the condition of having an undescended testis or testicles
Most commonly found in teens
torsion
True/False Yolk sac tumors always have increased blood levels of AFP
true
Small, anechoic cyst within the mediastinum of the testis
tubular ectasia of rete testis
Most common cause of correctable male infertility
varicocele
