Varicocele: Difference between revisions
| Line 11: | Line 11: | ||
**"Bag of worms" | **"Bag of worms" | ||
**More prominent w/ standing or Valsalva | **More prominent w/ standing or Valsalva | ||
**Does not transilluminate | |||
==DDx== | ==DDx== | ||
Revision as of 18:13, 18 February 2015
Background
- Peak incidence: onset of puberty
- Dilatation of spermatic cord veins (pampiniform plexus)
- ~90% occur on left
- Can impair sperm production/function
- Sudden appearance may be related to renal malignancy obstructing venous return
Diagnosis
- Hx: Dullness/heaviness/scrotal discomfort
- Physical exam
- "Bag of worms"
- More prominent w/ standing or Valsalva
- Does not transilluminate
DDx
Testicular Diagnoses
- Scrotal cellulitis
- Epididymitis
- Fournier gangrene
- Hematocele
- Hydrocele
- Indirect inguinal hernia
- Inguinal lymph node (Lymphadenitis)
- Orchitis
- Scrotal abscess
- Spermatocele
- Tinea cruris
- Testicular rupture
- Testicular torsion
- Testicular trauma
- Testicular tumor
- Torsion of testicular appendage
- Varicocele
- Pyocele
- Testicular malignancy
- Scrotal wall hematoma
Treatment
- Scrotal support
Disposition
- Referral to urologist
- Implications of possible subfertility should be discussed by urologist
See Also
Source
Tintinalli