TESTES
Varicocele is a dilated pampiniform venous plexus and
internal spermatic vein, usu-ally on the left side. It may cause infertility.
Clinically, it resembles a “bag of worms” superior to the testicle.
Hydrocele refers to fluid within the tunica vaginalis.
Spermatocele is an epididymal cyst containing sperm. On
physical examination it transilluminates.
Epididymitis presents with fever and gradual onset of
scrotal pain.
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Acute epididymitis that affects men age <35 is often caused by N. gonorrhoeae or C. trachomatis.
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Acute epididymitis that affects men age >35 is often caused by E. coli or Pseu-domonas.
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Chronic epididymitis can be caused by TB.
Orchitis presents with sudden onset of testicular pain
and fever. It is frequently viral, particularly due to the mumps
virus.
Testicular torsion is twisting of the spermatic
cord; may be associated with physical activity or trauma; and is a
clinical emergency that can cause painful hemorrhagic infarction leading to
gangrene.
Cryptorchidism is a failure of one or both
testes to descend; the undescended testes are most commonly found in
the inguinal canal. The undescended testes have an increased risk for developing
seminoma.
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Decreased sperm count due to primary
testicular dysfunction can be caused by Leydig cell dysfunction or
seminiferous tubule dysfunction.
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Decreased sperm count due to secondary
hypogonadism can be caused by pituitary and hypothalamic dysfunction.
•
Inability of sperm to exit the body in sufficient numbers may be
caused by obstruction of the vas
deferens or disordered ejaculation.
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