SYMPTOMS RELATED TO THE EXTERNAL GENITALIA Testis

SYMPTOMS RELATED TO THE EXTERNAL GENITALIA Testis

A testis may be absent from the scrotum in patients with unde - scended or ectopic testes. In boys <5 years, a common cause of testicular pain and swelling is torsion of a hydatid of Morgagni (appendix testis). In a young male suspected of having a testicular torsion, exam - ination of the normal, i.e. contralateral, testis may reveal a horizontal lie or ‘clapper bell testis’, raising the level of clinical suspicion. If torsion is suspected, immediate testicular explo - ration is mandatory and, if confirmed, bilateral testicular fix - a tion is performed. A Doppler USS may aid in the diagnosis. Patients with Klinefelter’s syndrome have bilateral small, firm testes in addition to the other signs typical of this con - dition. A hydrocele is an accumulation of fluid between the testis - and the tunica vaginalis; in the younger male it can be associ - ated with a patent pr ocessus vaginalis. The hydrocele fluid is typically a yellow colour. A testis that cannot be felt in a tense h ydrocele, in the age groups at risk of testicular cancer, needs to be assessed by USS.