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  • Hydrocele testis


    A hydrocele testis is an accumulation of clear fluid in the tunica vaginalis, the most internal of membranes containing a testicle. A primary hydrocele causes a painless enlargement in the scrotum on the affected side and is thought to be due to the defective absorption of fluid secreted between the two layers of the tunica vaginalis (investing membrane). A secondary hydrocele is secondary to either inflammation or a neoplasm in the testis. Scrotal ultrasound of a 1 dm large hydrocele, with anechoic (dark) fluid surrounding the testicle. A hydrocele usually occurs on one side, but can also affect both sides. The accumulation can be a marker of physical trauma, infection, tumor or varicocele surgery, but the cause is generally unknown. Indirect inguinal hernia indicates increased risk of hydrocele. A hydrocele is normally seen in infant boys, as an enlarged scrotum. In infant girls, it appears as enlarged labia. However, hydroceles are more common in boys than girls.

  • Testicular pain


    Testicular pain, also known as scrotal pain, occurs when part or all of either one or both testicles hurt. Pain in the scrotum is also often included. Testicular pain may be either short or long duration. Causes range from non serious muscular skeletal problems to emergency conditions such as Fournier's gangrene and testicular torsion. The diagnostic approach involves making sure no serious conditions are present. Testing may include ultrasound and blood tests. Pain management is typically given with definitive management depending on the underlying cause.

  • Testicular torsion


    Testicular torsion occurs when the spermatic cord (from which the testicle is suspended) twists, cutting off the blood supply to the testicle. The most common symptom in children is sudden, severe testicular pain. The testicle may be higher than usual in the scrotum and vomiting may occur. In newborns pain is often absent and instead the scrotum may become discolored or the testicle may disappear from its usual place. Most of those affected have no obvious prior underlying health problems. Testicular tumor or prior trauma may increase risk. Other risk factors include a congenital malformation known as a "bell-clapper deformity" wherein the testis is inadequately attached to the scrotum allowing it to move more freely and thus potentially twist. Cold temperatures may also be a risk factor. The diagnosis should usually be made based on the presenting symptoms. An ultrasound can be useful when the diagnosis is unclear. Treatment is by physically untwisting the testicle, if possible, followed by surgery. Pain can be treated with opioids. Outcome depends on time to correction. If successfully treated within six hours onset, it is often good, however, if delayed for 12 or more hours the testicle is typically not salvageable. About 40% of people require removal of the testicle. It is most common just after birth and during puberty. It occurs in about 1 in 4,000 to 1 in 25,000 males under 25 years of age each year. Of children with testicular pain of rapid onset, testicular torsion is the cause of about 10% of cases. Complications may include an inability to have children. The condition was first described in 1840 by Louis Delasiauve.

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