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Classification and pathology Tumours of the testis are classified according to their predom inant cellular type: /uni25CF GCTs (90–95%): these include seminoma, embryonal cell carcinoma, yolk sac tumour, teratoma and choriocarci noma; /uni25CF sex cord–stromal ...

Clinical features When assessing a child with suspected testicular maldescent, it is helpful to have the boy as relaxed as possible in a warm room, usually in a supine position. The important di ff erential diagnosis is the so-called ‘retractile testis’. During...

Consequences Infertility Men with undescended testes may have reduced fertility , even after orchidopexy . /uni25CF The infertility rate for unilateral cases is not believed to be very di ff erent from the general population. /uni25CF The fertility reduction af...

Differential diagnosis Skin redness and mild pyrexia may result in the condition being confused with epididymo-orchitis in the older patient; however, there will usually be dysuria associated with an accompanying urinary infection. Elevation of the testis red...

Epididymal cysts These are filled with a clear fluid. They are very common, usually multiple and vary in size at presentation. They represent cystic degeneration of the epididymis. Cysts of the epididymis are usually found in middle age and are often bilateral...

FURTHER READING Brierley JD, Gospodarowicz MK, Wittekind C (eds). TNM classification of malignant tumours , 8th edn. Oxford: Wiley Blackwell/Union for International Cancer Control, 2017. Laguna MP , Albers P , Algaba F et al . EAU guidelines on testicular canc...

Filarial hydroceles and chyloceles Filarial hydroceles and chyloceles account for up to 80% of hydroceles in tropical countries, where the parasite Wuchereria bancrofti is endemic. Filarial hydroceles follow repeated attacks of filarial epididymo-orchitis. Occ...

HYDROCELE Definition A hydrocele is an abnormal collection of serous fluid in a part of the processus vaginalis, usually the tunica vaginalis around - the testis and occasionally along the spermatic cord. Acquired hydroceles are primary or idiopathic, or second...

INCOMPLETE DESCENT OF THE TESTIS Definition Incomplete descent of the testis, also known as cryptorchidism, occurs when one or both testes are arrested at some point in the normal path to the scrotum. An ectopic testis is a testis that is abnormally placed out...

INFECTIONS OF THE TESTIS AND EPIDIDYMIS Epididymo-orchitis Definition Inflammation confined to the epididymis is epididymitis; if this inflammation, usually due to infection, involves the testis it is called epididymo-orchitis. Incidence Epididymitis, commonly pr...

Impalpable testis For non-palpable testes under anaesthesia, diagnostic laparos - copy is recommended. If a testis is found during laparoscopy , the options are: 1 Laparoscopic orchidopexy preserving the vessels: the testis is dissected o ff a triangular pedic...

Incidence About 3% of full-term and 30% of premature male infants are born with one or both testes undescended. About two-thirds of these reach the scrotum during the first 3 months of life, but full descent after that is uncommon. The incidence of testicul...

Introduction No content extracted automatically.

Investigation and staging The diagnosis is confirmed by ultrasound scanning of the testis ( Figure 86.16 ), which is also able to assess the contralateral testis. It is a mandatory test in all suspected cases of testicular tumour. In confirmed cases, staging i...

Learning objectives To diagnose and manage: Testicular maldescent • Testicular torsion • Common scrotal swellings (varicocele, hydrocele and • epididymal cysts)

Management The management of the case should be determined primarily on clinical grounds. While Doppler ultrasound scanning ( Figure 86.6 ) can confirm the absence of the blood supply to the a ff ected testis, false-positive results can be seen so it is not ro...

Medical treatment There is little evidence currently for hormonal therapy to induce testicular descent, with low response rates (equivalent to placebo) and a lack of long-term e ffi cacy .

Other common forms of orchitis Mumps orchitis, which is the most common form of orchitis, - develops in 20–30% of postpubertal patients with a mumps virus infection and it usually develops as the parotid swelling is waning. Evidence of immunoglobulin M antib...