Scrotal mass evaluation: Difference between revisions

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Latest revision as of 16:34, 27 November 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

If there is an acutely painful scrotum,there should be a strong suspicion for testicular torsion, which is an emergency condition, and emergent surgical referral should be strongly considered. Sonography may be performed if testicular torsion is not suspected to confirm the diagnosis.^[1]

Evaluation of Scrotal Mass

If there is an acutely painful scrotum,there should be a strong suspicion for testicular torsion, which is an emergency condition, and emergent surgical referral should be strongly considered. Sonography may be performed if testicular torsion is not suspected to confirm the diagnosis.^[1]
The evaluation of scrotal mass is as follows:^[1]

Evaluation of the scrotal mass

Painful

Nonpainful

High-riding or horizontal testicle; nausea/vomiting?

Transilluminates?

Yes

No

Yes

No

Presumed torsion
Doppler ultrasonogram,
urology consult

Blue dot sign?

Hydrocele

"Bag of worms" on palpation that increases on Valsalva maneuvers

Yes

No

Yes

No

Torsion of testicular appendage

Lack of blood flow on doppler sonogram, C-reactive protein level <24 mg per L

Varicocele

Reducible mass?

Yes

No

Yes

No

Testicular torsion; urgent surgery

Likely epididymitis/orchitis, possibly incarcerated inguinal hernia, or hemorrhagic testicular cancer

Hernia

Extratesticular and nontender

Yes

No

Likely benign, further workup as needed

Doppler sonography prior to urology evaluation

Unilateral mass

Evaluate for testicular cancer: AFP, B-HCG, and LDH levels; MRI or CT scans may be considered to look for possible metastases and cryopreservation of sperm while awaiting urology evaluation

Adapted from American academy of family physicians.^[2]

References

↑ ^1.0 ^1.1 ^1.2 Scrotal mass. American Academy of Family Physicians 2016. http://www.aafp.org/afp/2008/1115/p1165.html. Accessed on March 18, 2016
↑ Evaluation of scrotal mass. American academy of family physicians 2016. http://www.aafp.org/afp/2008/1115/p1165.html. Accessed on March 22, 2016

Template:WS Template:WH

[causescrotalmass1-1] 1.0 ^1.1 ^1.2 Scrotal mass. American Academy of Family Physicians 2016. http://www.aafp.org/afp/2008/1115/p1165.html. Accessed on March 18, 2016

[pescrotalmass1-2] Evaluation of scrotal mass. American academy of family physicians 2016. http://www.aafp.org/afp/2008/1115/p1165.html. Accessed on March 22, 2016

[1]

[2]

@@ Line 1: / Line 1: @@
+__NOTOC__
+{{Scrotal mass}}
+{{CMG}}{{AE}}{{SR}}
+==Overview==
+If there is an acutely painful scrotum,there should be a strong suspicion for testicular torsion, which is an emergency condition, and emergent surgical referral should be strongly considered. Sonography may be performed if testicular torsion is not suspected to confirm the diagnosis.<ref name=causescrotalmass1>Scrotal mass. American Academy of Family Physicians 2016. http://www.aafp.org/afp/2008/1115/p1165.html. Accessed on March 18, 2016</ref>
+==Evaluation of Scrotal Mass==
+*If there is an acutely painful scrotum,there should be a strong suspicion for testicular torsion, which is an emergency condition, and emergent surgical referral should be strongly considered. Sonography may be performed if testicular torsion is not suspected to confirm the diagnosis.<ref name=causescrotalmass1>Scrotal mass. American Academy of Family Physicians 2016. http://www.aafp.org/afp/2008/1115/p1165.html. Accessed on March 18, 2016</ref>
+*The evaluation of scrotal mass is as follows:<ref name=causescrotalmass1>Scrotal mass. American Academy of Family Physicians 2016. http://www.aafp.org/afp/2008/1115/p1165.html. Accessed on March 18, 2016</ref>
 {{familytree/start |summary=Evaluation of the scrotal mass}}
 {{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | | | | | A01 |A01=<div style="width: 9em; padding:0.2em;">'''Evaluation of the scrotal mass'''</div>}}
@@ Line 6: / Line 17: @@
 {{familytree |boxstyle=background: #DCDCDC;| | | | | | | C01 | | | | | | | | | | | | | | C02 | |C01=<div style="width: 9em; padding:0.2em;">High-riding or horizontal testicle; nausea/vomiting?</div>|C02=<div style="width: 9em; padding:0.2em;">Transilluminates?</div>}}
 {{familytree |boxstyle=background: #DCDCDC;| | | |,|-|-|-|^|-|-|-|.| | | | | | | |,|-|-|-|^|-|-|-|.| |}}
-{{familytree |boxstyle=background: #DCDCDC;| | | C03 | | | | | | C04 | | | | | | C05 | | | | | | C06 | |C03=<div style="width: 9em; padding:0.2em;">Yes</div>|C04=<div style="width: 9em; padding:0.2em;">No</div>}}|C05=<div style="width: 9em; padding:0.2em;">Yes</div>|C06=<div style="width: 9em; padding:0.2em;">No</div>}}}}
+{{familytree |boxstyle=background: #DCDCDC;| | | C03 | | | | | | C04 | | | | | | C05 | | | | | | C06 | |C03=<div style="width: 9em; padding:0.2em;">Yes</div>|C04=<div style="width: 9em; padding:0.2em;">No</div>|C05=<div style="width: 9em; padding:0.2em;">Yes</div>|C06=<div style="width: 9em; padding:0.2em;">No</div>}}
 {{familytree |boxstyle=background: #DCDCDC;| | | |!| | | | | | | |!| | | | | | | |!| | | | | | | |!| |}}
 {{familytree |boxstyle=background: #DCDCDC;| | | D01 | | | | | | D02 | | | | | | D03 | | | | | | D04 |D01=<div style="width: 9em; padding:0.2em;">Presumed torsion<br>Doppler ultrasonogram,<br>urology consult</div>|D02=<div style="width: 9em; padding:0.2em;">Blue dot sign?</div>|D03=<div style="width: 9em; padding:0.2em;">Hydrocele</div>|D04=<div style="width: 9em; padding:0.2em;">"Bag of worms" on palpation that increases on Valsalva maneuvers</div>}}
 {{familytree |boxstyle=background: #DCDCDC;| | | | | | | |,|-|-|-|^|-|-|-|.| | | | | | | |,|-|-|-|^|-|-|-|.| |}}
+{{familytree |boxstyle=background: #DCDCDC;| | | | | | | A02 | | | | | | A03 | | | | | | A04 | | | | | | A05 |A02=<div style="width: 9em; padding:0.2em;">Yes</div>|A03=<div style="width: 9em; padding:0.2em;">No</div>|A04=<div style="width: 9em; padding:0.2em;">Yes</div>|A05=<div style="width: 9em; padding:0.2em;">No</div>}}
+{{familytree |boxstyle=background: #DCDCDC;| | | | | | | |!| | | | | | | |!| | | | | | | |!| | | | | | | |!| |}}
 {{familytree |boxstyle=background: #DCDCDC;| | | | | | | E01 | | | | | | E02 | | | | | | E03 | | | | | | E04 |E01=<div style="width: 9em; padding:0.2em;">Torsion of testicular appendage</div>|E02=<div style="width: 9em; padding:0.2em;">Lack of blood flow on doppler sonogram, C-reactive protein level <24 mg per L</div>|E03=<div style="width: 9em; padding:0.2em;">Varicocele</div>|E04=<div style="width: 9em; padding:0.2em;">Reducible mass?</div>}}
-{{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | |,|-|-|-|^|-|-|-|.| | |}}
+{{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | |,|-|-|-|^|-|-|-|.| | | | | | | |,|-|-|-|^|-|-|-|.| |}}
-{{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | F01 | | | | | | F02 |F01=<div style="width: 9em; padding:0.2em;">Testicular torsion; urgent surgery</div>|F02=<div style="width: 9em; padding:0.2em;">Likely epididymitis/orchitis, possibly incarcerated inguinal hernia, or hemorrhagic testicular cancer</div>}}
+{{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | E05 | | | | | | E06 | | | | | | E07 | | | | | | E08 |E05=<div style="width: 9em; padding:0.2em;">Yes</div>|E06=<div style="width: 9em; padding:0.2em;">No</div>|E07=<div style="width: 9em; padding:0.2em;">Yes</div>|E08=<div style="width: 9em; padding:0.2em;">No</div>}}
+{{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | |!| | | | | | | |!| | | | | | | |!| | | | | | | |!| | |}}
+{{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | F01 | | | | | | F02 | | | | | | F03 | | | | | | F04 | |F01=<div style="width: 9em; padding:0.2em;">Testicular torsion; urgent surgery</div>|F02=<div style="width: 9em; padding:0.2em;">Likely epididymitis/orchitis, possibly incarcerated inguinal hernia, or hemorrhagic testicular cancer</div>|F03=<div style="width: 9em; padding:0.2em;">Hernia</div>|F04=<div style="width: 9em; padding:0.2em;">Extratesticular and nontender</div>}}
+{{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |,|-|-|-|^|-|-|-|.| |}}
+{{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | F05 | | | | | | F06 |F05=<div style="width: 9em; padding:0.2em;">Yes</div>|F06=<div style="width: 9em; padding:0.2em;">No</div>}}
+{{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | | | | |!| |}}
+{{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | G01 | | | | | | G02 |G01=<div style="width: 9em; padding:0.2em;">Likely benign, further workup as needed</div>|G02=<div style="width: 9em; padding:0.2em;">Doppler sonography prior to urology evaluation</div>}}
+{{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |!| |}}
+{{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | H01 | |H01=<div style="width: 9em; padding:0.2em;">Unilateral mass</div>}}
+{{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |!| |}}
+{{familytree |boxstyle=background: #DCDCDC;| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | I01 | |I01=<div style="width: 9em; padding:0.2em;">Evaluate for testicular cancer: AFP, B-HCG, and  LDH levels; MRI or CT scans may be considered to look for possible metastases and cryopreservation of sperm while awaiting urology evaluation</div>}}
+{{familytree/end}}
+<SMALL>Adapted from American academy of family physicians.<ref name=pescrotalmass1>Evaluation of scrotal mass. American academy of family physicians 2016. http://www.aafp.org/afp/2008/1115/p1165.html. Accessed on March 22, 2016</ref></SMALL>
-{{familytree/end}}
+==References==
+{{reflist|2}}
+[[Category:Diseases]]
+[[Category:Oncology]]
+{{WS}}
+{{WH}}
+ [[Category:Up-To-Date]]
+[[Category:Oncology]]
+[[Category:Medicine]]
+[[Category:Urology]]
+ [[Category:Up-To-Date]]
+[[Category:Oncology]]
+[[Category:Medicine]]
+[[Category:Urology]]

Scrotal mass evaluation: Difference between revisions

Latest revision as of 16:34, 27 November 2017

Overview

Evaluation of Scrotal Mass

References

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