00:01
Here, we’ll take a
look at the scrotum.
00:04
Up until now, we’ve
looked penile pathology.
00:06
I’ve walked you
through varicocele
and also looked at
testicular torsion.
00:10
And each one of those points
are incredibly important,
make sure you know
clinical presentation
and also management for
every single board.
00:17
Scrotal masses,
well it depends on what the
consistency of the mass is, okay?
For example,
if you find that the scrotal mass
can be either transilluminating
or you can have scrotal
mass that might be solid
and that to you should
mean testicular tumors.
00:34
So now, with that said,
what is the most common
enlargement of your scrotum?
Varicocele.
00:42
Which side of the testis?
Or which side of the scrotum?
Left side.
00:47
Let’s take a look at
congenital hydrocele.
00:51
Here, common cause of
transillumninating.
00:54
Would you tell me as to what the
illumination was with varicocele?
It didn’t.
00:59
It did not transilluminate.
01:01
Varicocele.
01:03
Why?
Because in the veins,
we have thick blood.
01:08
It does not transilluminate.
01:10
If it’s fluid, yes it will.
01:14
Congenital hydrocele,
common cause of transilluminating
scrotal swelling in infants.
01:18
What happened here?
Congenital hydrocele is due to
incomplete obliteration of the processus vaginalis.
01:26
Remember please your
patient is a boy.
01:28
Boy, boy.
01:29
Genotypic and phenotypic.
01:31
Acquired hydrocele:
How did the patient
acquire the hydrocele?
Scrotal fluid collection usually
secondary to infection,
maybe perhaps trauma.
01:42
And if it’s bloody, you
would call this hematocele.
01:46
Spermatocele:
What is this?
It’s paratesticular
fluctuant nodular cyst
formed by the obstruction
of the rete testis
or the epididymal passage,
exactly as the name implies.
02:02
I want you to picture now.
02:04
Close your eyes and think
about the Sertoli cells,
and they all form at
the apical membrane,
what lumen is this?
Surrounding cells, Sertoli.
02:15
What’s the lumen that
it produces or creates?
The seminiferous tubule, right?
Can you picture
that in the testis?
And then from the seminiferous
tubules, you have the rete testis.
02:26
And then you have the
epididymis, vas and so forth, all right?
So then that’s the passage
that you should have in mind.
02:32
What happens is that
if you have a cyst,
an obstruction of rete testis
or epididymal passage,
resulting in a diverticuli
with sperm-containing fluid.
02:44
Exactly as to what
the name implies.
02:46
Your sperm is not in the vein.
02:48
Your sperm is not in the artery.
02:49
It’s in the seminiferous tubule.
02:52
So if you’re thinking about sperm
and fluid being accumulated.
02:56
Do you understand you
have to be in the passage
from the the seminiferous
tubule out into, you know,
the vesicle, seminal vesicles.
03:05
Are we clear?
Now, it is often the presence
of debris with the cyst
that distinguishes spermatocele
from simple cyst of the epididymis,
that’s a little bit more detailed
than might be necessary.
03:18
At this point, it would
behoove you to at least know
the differences between
congenital and acquired hydrocele,
varicocele and spermatocele.