Causes of Testicle disorders
Testicle disorders Causes: Book Excerpts
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Scrotal Swelling:
Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)
- Hydrocele
–Fluid surrounding the testicle
–Typically seen in infancy
–Results from remnant of testicular descent from the abdomen through the inguinal canal into the scrotum
–May be communicating or noncommunicating; communicating hydroceles have retained patency of the tract of descent, and noncommunicating hydroceles do not
–Communicating hydroceles may be reducible and are likely to fluctuate in size depending on the amount of fluid within the scrotal sac; crying or any increase in intra-abdominal pressure results in an increase in size
–Usually is noncommunicating; i.e., not reducible, and does not change in size with crying
–Testes may be difficult to palpate because surrounded by the hydrocele
- Hernia
–Protrusion of a loop of bowel into the scrotum
–Direct hernias represent a channel directly through the musculature of the pelvic floor; indirect hernias have proceeded through the inguinal canal
–Usually painless unless incarcerated
–Usually reducible and changes in size with changes in intra-abdominal pressure
–Testes usually palpable below the hernia
-
Varicocele
–A collection of dilated veins in the scrotum
–Usually painless, but patients may complain
of heaviness
-
Edema
–Generalized edema often is accompanied by scrotal edema
-
Tumor
–Presents as painless nodule on testes
–May be accompanied by sexual precocity or
gynecomastia secondary to hormone production by the tumor
-
Leukemia
–Patients may present with unilateral scrotal swelling (common site for relapse)
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Scrotal swelling:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
Epididymal cysts
Located in the head of the epididymis, epididymal cysts produce painless scrotal swelling.
Epididymitis
Key features of inflammation are pain, extreme tenderness, and swelling in the groin and scrotum. The patient waddles to avoid pressure on the groin and scrotum during walking. He may have a high fever, malaise, an urethral discharge and cloudy urine, and lower abdominal pain on the affected side. His scrotal skin may be hot, red, dry, flaky, and thin.
Hydrocele
Fluid accumulation produces gradual scrotal swelling that’s usually painless. The scrotum may be soft and cystic or firm and tense. Palpation reveals a round, nontender scrotal mass.
Idiopathic scrotal edema
Swelling occurs quickly with idiopathic scrotal edema and usually disappears within 24 hours. The affected testicle is pink.
Orchitis (acute)
Mumps, syphilis, or tuberculosis may precipitate orchitis, which causes sudden painful swelling of one or, at times, both testicles. Related findings include a hot, reddened scrotum; a fever of up to 104° F (40° C); chills; lower abdominal pain; nausea; vomiting; and extreme weakness. Urinary signs are usually absent.
Scrotal trauma
Blunt trauma causes scrotal swelling with bruising and severe pain. The scrotum may appear dark or bluish.
Spermatocele
Spermatocele is a usually painless cystic mass that lies above and behind the testicle and contains opaque fluid and sperm. Its onset may be acute or gradual. Less than 1 cm in diameter, it’s movable and may be transilluminated.
Testicular torsion
Most common before puberty, testicular torsion is a urologic emergency that causes scrotal swelling; sudden, severe pain; and, possibly, elevation of the affected testicle within the scrotum. It may also cause nausea and vomiting.
Testicular tumor
Typically painless, smooth, and firm, a testicular tumor produces swelling and a sensation of excessive weight in the scrotum.
Torsion of a hydatid of Morgagni
Torsion of this small, pea-sized cyst severs its blood supply, causing a hard, painful swelling on the testicle’s upper pole.
Other causes
Surgery
An effusion of blood from surgery can produce a hematocele, leading to scrotal swelling.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Hypogonadism:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
Primary hypogonadism results directly from interstitial (Leydig’s cell) cellular or seminiferous tubular damage due to faulty development or mechanical damage. This causes increased secretion of gonadotropins by the pituitary in an attempt to increase the testicular functional state and is therefore termed hypergonadotropic hypogonadism. This form of hypogonadism includes Klinefelter syndrome, Reifenstein’s syndrome, Turner syndrome, Sertoli-cell-only syndrome, anorchism, orchitis, and sequelae of irradiation.
Secondary hypogonadism is due to faulty interaction within the hypothalamic-pituitary axis, resulting in failure to secrete normal levels of gonadotropins, and is therefore termed hypogonadotropic hypogonadism. This form of hypogonadism includes hypopituitarism, isolated follicle-stimulating hormone deficiency, isolated luteinizing hormone deficiency, Kallmann’s syndrome, and Prader-Willi syndrome. Depending on the patient’s age at onset, hypogonadism may cause eunuchism (complete gonadal failure) or eunuchoidism (partial failure).
Medications, such as exogenous testosterone or anabolic steroids, can also cause of hypogonadism, resulting in infertility.
Hypogonadism is rare, and it has no racial predilection.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Testicular torsion:
Causes
(Professional Guide to Diseases (Eighth Edition))
Normally, the tunica vaginalis envelops the testis and attaches to the epididymis and spermatic cord. In intravaginal torsion (the most common type of testicular torsion in adolescents), testicular twisting may result from an abnormality of the tunica, in which the testis is abnormally positioned, or from a narrowing of the mesentery support. In extravaginal torsion (most common in neonates), loose attachment of the tunica vaginalis to the scrotal lining causes spermatic cord rotation above the testis. Typically, there’s no history of trauma, and the pain occurs suddenly. A sudden forceful contraction of the cremaster muscle may precipitate this condition. (See Extravaginal torsion.)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Scrotal swelling:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Elephantiasis of the scrotum
With this disorder (common in some tropical countries), infection by a filaria worm obstructs lymphatic drainage, causing chronic gross scrotal edema and pain. Associated findings include other areas of pitting and, eventually, brawny edema (especially the legs), thickened subcutaneous tissue, hyperkeratosis, and skin fissures.
Epididymal cysts
Located in the head of the epididymis, these cysts produce painless scrotal swelling.
Epididymal tuberculosis
This disorder produces an enlarged scrotal mass separated from the testicle. Other findings include palpable beading along the vas deferens, induration of the prostate or seminal vesicles, and pus or tubercle bacilli in the urine.
Epididymitis
Key features of inflammation are pain, extreme tenderness, and swelling in the groin and scrotum. The patient waddles to avoid pressure on the groin and scrotum during walking. He may have high fever, malaise, urethral discharge and cloudy urine, and lower abdominal pain on the affected side. His scrotal skin may be hot, red, dry, flaky, and thin.
Gumma
This rare, painless nodule—usually associated with benign tertiary syphilis—can affect any bone or organ. If it affects the testicle, it causes edema.
Hernia
Herniation of bowel into the scrotum can cause swelling and a soft or unusually firm scrotum. Occasionally, bowel sounds can be auscultated in the scrotum.
Hydrocele
Fluid accumulation produces gradual scrotal swelling that’s usually painless. The scrotum may be soft and cystic or firm and tense. Palpation reveals a round, nontender scrotal mass.
Idiopathic scrotal edema
Swelling occurs quickly with this disorder and usually disappears within 24 hours. The affected testicle is pink.
Orchitis (acute)
Mumps, syphilis, or tuberculosis may precipitate this disorder, which causes sudden painful swelling of one or, at times, both testicles. Related findings include a hot, reddened scrotum; fever of up to 104° F (40° C); chills; lower abdominal pain; nausea; vomiting; and extreme weakness. Urinary signs are usually absent.
Scrotal burns
Burns cause swelling within 24 hours of injury. Depending on the burn’s severity, associated findings may include severe pain, erythema, chafing, tissue sloughing, and maceration with a weeping exudate.
Scrotal trauma
Blunt trauma causes scrotal swelling with bruising and severe pain. The scrotum may appear dark or bluish.
Spermatocele
This usually painless cystic mass lies above and behind the testicle and contains opaque fluid and sperm. Its onset may be acute or gradual. Less than 1 cm in diameter, it’s movable and may be transilluminated.
Testicular torsion
Most common before puberty, this urologic emergency causes scrotal swelling; sudden, severe pain; and, possibly, elevation of the affected testicle within the scrotum. It may also cause nausea and vomiting.
Testicular tumor
Typically painless, smooth, and firm, a testicular tumor produces swelling and a sensation of excessive weight in the scrotum.
Torsion of a hydatid of Morgagni
Torsion of this small, pea-sized cyst severs its blood supply, causing a hard, painful swelling on the testicle’s upper pole.
Other causes
Surgery
An effusion of blood from surgery can produce a hematocele, leading to scrotal swelling.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Scrotal Pain/Swelling:
Differential Overview
(Field Guide to Bedside Diagnosis)
Pain Predominant
❑ Epididymitis
❑ Testicular torsion
❑ Prostatitis
❑ Referred pain
❑ Trauma
❑ Orchitis
❑ Torsion of the appendix testis
❑ Inguinal hernia/incarcerated
Swelling Predominant
❑ Varicocele
❑ Inguinal hernia
❑ Hydrocele
❑ Spermatocele
❑ Sebaceous cyst
❑ Testicular cancer
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Scrotal swelling:
Medical causes
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Elephantiasis of the scrotum
With elephantiasis of the scrotum (common in some tropical countries), infection by a filaria worm obstructs lymphatic drainage, causing chronic gross scrotal edema and pain. Associated findings include other areas of pitting and, eventually, brawny edema (especially the legs), thickened subcutaneous tissue, hyperkeratosis, and skin fissures.
Epididymal cysts
.Located in the head of the epididymis, these cysts produce painless scrotal swelling.
Epididymal tuberculosis
Epididymal tuberculosis produces an enlarged scrotal mass separated from the testicle. Other findings include palpable beading along the vas deferens, induration of the prostate or seminal vesicles, and pus or tubercle bacilli in urine.
Epididymitis
Key features of inflammation are pain, extreme tenderness, and swelling in the groin and scrotum. The patient waddles to avoid pressure on the groin and scrotum during walking. He may have high fever, malaise, urethral discharge and cloudy urine, and lower abdominal pain on the affected side. His scrotal skin may be hot, red, dry, flaky, and thin.
Gumma
Gumma is a rare, painless nodule — usually associated with benign tertiary syphilis — that can affect any bone or organ. If it affects the testicle, it causes edema.
Hernia
Herniation of bowel into the scrotum can cause swelling and a soft or unusually firm scrotum. Occasionally, bowel sounds can be auscultated in the scrotum.
Hydrocele
Fluid accumulation produces gradual scrotal swelling that’s usually painless. The scrotum may be soft and cystic or firm and tense. Palpation reveals a round, nontender scrotal mass.
Idiopathic scrotal edema
Swelling occurs quickly with idiopathic scrotal edema and usually disappears within 24 hours. The affected testicle is pink.
Orchitis (acute)
Mumps, syphilis, or tuberculosis may precipitate acute orchitis, which causes sudden painful swelling of one or, at times, both testicles. Related findings include a hot, reddened scrotum accompanied by fever of up to 104° F (40° C), chills, lower abdominal pain, nausea, vomiting, and extreme weakness. Urinary signs are usually absent.
Scrotal burns
Burns cause swelling within 24 hours of injury. Depending on the burn’s severity, associated findings may include severe pain, erythema, chafing, tissue sloughing, and maceration with a weeping exudate.
Scrotal trauma
Blunt trauma causes scrotal swelling with bruising and severe pain. The scrotum may appear dark or bluish.
Spermatocele
This usually painless cystic mass lies above and behind the testicle and contains opaque fluid and sperm. Its onset may be acute or gradual. Less than 1 cm in diameter, it’s movable and may be transilluminated.
Testicular torsion
Most common between ages 12 and 25 years, testicular torsion — a urologic emergency — causes scrotal swelling with sudden, severe pain and, possibly, elevation of the affected testicle within the scrotum. It may also cause nausea and vomiting.
Testicular tumor
Typically painless, smooth, and firm, a testicular tumor produces swelling and a sensation of excessive weight in the scrotum.
Torsion of a hydatid of Morgagni
Torsion of a hydatid of Morgagni — a small, pea-sized cyst — severs its blood supply, causing hard, painful swelling on the testicle’s upper pole.
Other causes
Surgery
An effusion of blood from surgery can produce a hematocele, leading to scrotal swelling.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Scrotal swelling:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Epididymal cysts
Located in the head of the epididymis, epididymal cysts produce painless scrotal swelling. Most men, however, are asymptomatic and discover the cyst on self-examination.
Epididymitis
Key features of epididymitis are inflammation, pain, extreme tenderness, and swelling in the groin and scrotum. The patient waddles to avoid pressure on the groin and scrotum during walking. He may have high fever, malaise, urethral discharge and cloudy urine, and lower abdominal pain on the affected side. His scrotal skin may be hot, red, dry, flaky, and thin.
Hernia
Herniation of bowel into the scrotum can cause swelling and a soft or unusually firm scrotum. Occasionally, bowel sounds can be auscultated in the scrotum. If bowel obstruction occurs, anorexia, nausea, vomiting, and reduced bowel sounds may occur.
Hydrocele
With hydrocele, fluid accumulation produces gradual scrotal swelling that’s usually painless. The scrotum may be soft and cystic or firm and tense. Palpation reveals a round, nontender scrotal mass.
Orchitis (acute)
Mumps, syphilis, or tuberculosis may precipitate acute orchitis, which causes sudden painful swelling of one or, at times, both testicles. Related findings include a hot, reddened scrotum; fever of up to 104° F (40° C); chills; lower abdominal pain; nausea; vomiting; and extreme weakness. Urinary signs are usually absent.
Scrotal trauma
Blunt trauma causes scrotal swelling with bruising and severe pain. The scrotum may appear dark or bluish. Nausea, vomiting, and difficulty urinating might also occur.
Spermatocele
A spermatocele, a usually painless cystic mass, lies above and behind the testicle and contains opaque fluid and sperm. Its onset may be acute or gradual. Less than 1 cm in diameter, it’s movable and may be transilluminated.
Testicular torsion
Most common before puberty, testicular torsion is a urologic emergency that causes scrotal swelling; sudden, severe pain; and, possibly, elevation of the affected testicle within the scrotum. Testicular torsion may also cause nausea and vomiting.
Testicular tumor
Typically painless, smooth, and firm, a testicular tumor produces swelling and a sensation of excessive weight in the scrotum. With ureteral obstruction, the patient may have urinary complaints.
Other causes
Surgery
An effusion of blood from surgery can produce a hematocele, leading to scrotal swelling.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Scrotal swelling:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Epididymal cysts. Located in the head of the epididymis, epididymal cysts produce painless scrotal swelling.
Epididymitis.Key features of epididymitis are pain, extreme tenderness, and swelling in the groin and scrotum. The patient waddles to avoid pressure on the groin and scrotum during walking. He may have a high fever, malaise, a urethral discharge and cloudy urine, and lower abdominal pain on the affected side. His scrotal skin may be hot, red, dry, flaky, and thin.
Hydrocele.With a hydrocele, fluid accumulation produces gradual scrotal swelling that's usually painless. The scrotum may be soft and cystic or firm and tense. Palpation reveals a round, nontender scrotal mass.
Idiopathic scrotal edema.Swelling occurs quickly with idiopathic scrotal edema and usually disappears within 24 hours. The affected testicle is pink.
Orchitis (acute).Mumps, syphilis, or tuberculosis may precipitate orchitis, which causes sudden painful swelling of one or, at times, both testicles. Related findings include a hot, reddened scrotum; a fever of up to 104° F (40° C); chills; lower abdominal pain; nausea; vomiting; and extreme weakness. Urinary signs are usually absent.
Scrotal trauma.Blunt trauma causes scrotal swelling with bruising and severe pain. The scrotum may appear dark or bluish.
Spermatocele.Spermatocele is a usually painless cystic mass that lies above and behind the testicle and contains opaque fluid and sperm. Its onset may be acute or gradual. Less than 1 cm in diameter, it's movable and may be transilluminated.
Testicular torsion.Most common before puberty, testicular torsion is a urologic emergency that causes scrotal swelling; sudden, severe pain; and, possibly, elevation of the affected testicle within the scrotum. It may also cause nausea and vomiting.
Testicular tumor.Typically painless, smooth, and firm, a testicular tumor produces swelling and a sensation of excessive weight in the scrotum.
Torsion of a hydatid of Morgagni.Torsion of this small, pea-size cyst severs its blood supply, causing a hard, painful swelling on the testicle's upper pole.
Other causes
Surgery.An effusion of blood from surgery can produce a hematocele, leading to scrotal swelling.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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