Painless scrotal swelling
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This document discusses various types of testicular tumors and conditions, including their symptoms, examination findings, and management. It describes testicular seminomas and teratomas, noting that teratomas arise from totipotent cells and contain three germ layers. It also discusses interstitial cell tumors of the testes, tuberculous epididymo-orchitis, chronic haematoceles, and gummas. For each condition, it provides details on clinical presentation, examination findings, diagnostic testing, and treatment options.
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Pelvic organ prolapse gynaecology ppt
genital prolapse uterine prolapse cystocele rectocele urethrocele anterior middle posterior compartments management sacroclopopexy ward mayos repair fothergills repair urogynaecology vaginal hysterectomy perineorrhaphy anterior colpopexy mesh repair khannas sling procedure pessaries
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A 33-year-old Omani woman presented with severe lower abdominal pain for 3 days after undergoing ICSI (intra-cytoplasmic sperm injection) treatment for primary infertility. She has a history of infertility for 6 years, including a failed IUI (intrauterine insemination) treatment 2 years ago. A physical exam and medical history were taken. The woman has been experiencing primary infertility for 6 years despite various fertility treatments.
COLPORRHAPHY.pptx
Colporrhaphy is a surgical procedure to repair pelvic organ prolapse such as cystocele or rectocele. It repairs defects in the anterior or posterior vaginal walls by plicating the fascia with sutures and using mesh to reinforce the repair. The procedure is performed under anesthesia, either general or regional. It aims to restore prolapsed organs and relieve symptoms like incontinence and pain. Success rates are high at 85-90%, though complications can include infection, recurrent prolapse or mesh erosion.
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This document discusses pelvic organ prolapse, including:
- A case scenario of a 43-year-old woman presenting with a mass descending from her vagina and difficulty initiating urination.
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- Common urinary symptoms like frequency, dysuria, stress incontinence, and retention.
- Examination findings like prolapse classification systems, differential diagnosis, and management options like conservative treatments, reconstructive surgery, obliterative procedures, and hysterectomy.
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Chyluria is a condition characterized by the presence of chyle or fatty lymph in the urine, causing it to appear milky white. It is most commonly caused by filarial infections in parts of Africa and India. The condition results from obstruction or insufficiency of the lymphatic system, causing retrograde flow of lymph into the urinary tract. Diagnosis involves urine tests to detect triglycerides and lymph. Treatment options include medication to treat underlying causes, sclerotherapy to scar lymphatic vessels, and surgery such as lymphatic disconnection or lymph node-vein anastomosis if more conservative treatments fail.
Pelvic organ prolapse gynaecology ppt
genital prolapse uterine prolapse cystocele rectocele urethrocele anterior middle posterior compartments management sacroclopopexy ward mayos repair fothergills repair urogynaecology vaginal hysterectomy perineorrhaphy anterior colpopexy mesh repair khannas sling procedure pessaries
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Laparoscopy is a minimally invasive surgical procedure that involves inserting a narrow telescope through a small incision in the abdomen to visualize internal organs. It can be used both diagnostically to investigate issues like infertility, masses, or suspected abnormalities, and therapeutically to treat conditions like endometriosis, myomas, ectopic pregnancies, and more. Potential risks include injuries to internal organs from trocar insertion or diathermy, bleeding, infection, and port site complications. Careful patient selection and surgical technique can help reduce risks.
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Colporrhaphy is a surgical procedure to repair pelvic organ prolapse such as cystocele or rectocele. It repairs defects in the anterior or posterior vaginal walls by plicating the fascia with sutures and using mesh to reinforce the repair. The procedure is performed under anesthesia, either general or regional. It aims to restore prolapsed organs and relieve symptoms like incontinence and pain. Success rates are high at 85-90%, though complications can include infection, recurrent prolapse or mesh erosion.
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- A hysteroscope is an endoscope used to visualize the uterine cavity and perform procedures.
- It describes the historical development of hysteroscopy from the 19th century to modern techniques.
- The types of hysteroscopes and instrumentation used are outlined, including distention media, electrodes, sheaths, and cameras.
- The document discusses the procedures, indications, contraindications and complications of diagnostic and operative hysteroscopy.
Rectal prolapse.pptx
The document provides tips for using a PowerPoint presentation on rectal prolapse. It recommends:
1. Freely editing and modifying the slides and adding your name.
2. Noting that half the slides are blank except for the title to facilitate active learning sessions.
3. Showing blank slides, asking students what they know, and then showing the content slide.
4. Rerunning the show at the end to reinforce learning.
5. Using this approach for 3 revisions to optimize learning.
It also provides the presentation format and sample content slides on topics like relevant anatomy, aetiology, clinical features, and management of rectal prolapse.
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Spermatocoele
Spermatocele is a benign cystic accumulation of sperm that arises from the head of the epididymis. It typically presents as an asymptomatic mobile swelling near the testicle. Ultrasound shows a hypoechoic cystic lesion connected to the epididymis. Treatment involves observation for small asymptomatic cases or spermatocelectomy via scrotal surgery to remove the cyst. Sclerotherapy is sometimes used as an alternative but has a higher recurrence rate.
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This document provides tips for using a PowerPoint presentation (PPT). It recommends:
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3. Showing blank slides first to elicit what students already know before presenting content.
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7. Notes provide the bibliography.
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This document discusses the anatomy and causes of cervical elongation. The normal cervix is approximately 2.5cm in length. Elongation can occur in the supravaginal or vaginal portions. Supravaginal elongation is commonly associated with uterine prolapse and puts strain on the cervix. Vaginal elongation is usually congenital and can cause symptoms like feeling of something coming down and dyspareunia. Physical exam can distinguish the two by determining if the elongation is in the uterine canal or vaginal portion. Treatment depends on the cause, with supravaginal elongation addressed like prolapse and congenital elongation requiring cervical amputation or cervicopexy.
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1) A 30-year-old man presented with right testicular swelling without pain or urinary symptoms. Examination found an enlarged right testis without tenderness or transillumination.
2) The document provides guidance on evaluating scrotal swellings, including asking about onset/progression, site, associated symptoms, and examination of the testis and epididymis.
3) Common causes of scrotal swelling discussed are hydrocele, epididymal cyst, and varicocele. Hydrocele is fluid between the testis layers, epididymal cyst is a fluid sac in the epididymis, and varicocele is dilated spermatic veins.
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This presentation is prepared to meet out the undergraduate medical student needs especially to understand the practical aspects of uterine fibroid and to rapidly revise some important viva questions.
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This document discusses the management of pelvic organ prolapse including conservative management with pelvic floor exercises and pessaries as well as surgical management. Surgical procedures are described to repair prolapse in the anterior compartment, posterior compartment, middle compartment, and for enterocele repair. Procedures are also summarized for vault prolapse, hysterectomy, and repair in nulliparous patients. Complications of treatment methods are also outlined.
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This document discusses follicular monitoring, which is used to track the growth of ovarian follicles using ultrasound. It is a vital part of assessing IVF and IUI cycles. Regular monitoring allows doctors to evaluate response to medication, adjust doses as needed, and time ovulation or procedures. Early in the cycle, several follicles are recruited and a dominant follicle is selected, growing larger each day. Monitoring involves tracking follicle size and number as well as blood flow. It helps determine when to trigger ovulation or collect eggs and can identify patients at risk for overstimulation.
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This document discusses potential causes of masses in the right iliac fossa, including appendicular abscess, appendicular mass, ileocecal tuberculosis, and carcinoma of the caecum. It provides characteristics of some common right iliac fossa masses like appendicular masses being tender, soft to firm, and having ill-defined borders, while ileocecal tuberculosis masses are firm to hard and highly placed. The document also reviews colon carcinoma risks such as aging, hereditary factors, and diet high in animal fat or low in fiber, as well as the pathogenesis involving mutations in microsatellite sequences regulating cell growth.
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This document discusses hemorrhoidectomy, which is the surgical excision of hemorrhoids. It defines hemorrhoidectomy and lists its indications. The types of hemorrhoidectomy procedures are open, closed, and stapled. Preoperative preparation includes a high fiber diet, stool softeners, and antibiotics. The procedure involves excising hemorrhoids using spinal or general anesthesia and leaving tissue bridges between excised areas. Post-operative management includes analgesia, laxatives, and sitz baths. Complications can include bleeding, urinary retention, impaction, stenosis, fissures, tags, recurrence, and incontinence.
Pelvic organ prolapse
This document provides an overview of pelvic organ prolapse. It defines prolapse as the descent of pelvic organs, like the bladder, bowel or uterus, into the vagina due to weakness in their supporting structures. It discusses the epidemiology, relevant anatomy, risk factors, classification, clinical features and management. Conservative options include lifestyle changes, pelvic floor exercises and pessaries. Surgical management ranges from repairs to more radical procedures like hysterectomy, depending on the severity of prolapse and patient factors. The goal of treatment is to relieve symptoms and support the pelvic organs in their proper anatomical position.
Vaginal Hysterectomy
Vaginal hysterectomy is a procedure to remove the uterus through the vagina. It has advantages over abdominal hysterectomy like earlier recovery, less pain, and lower morbidity. The key steps involve exposing and clamping the uterine vessels and ligaments, then removing the uterus. The vaginal cuff and pelvic floor are repaired with sutures to prevent prolapse. Post-operative care involves bladder drainage, antibiotics, pain relief, and monitoring for potential complications like bleeding or infection.
Bartholian cyst
A Bartholin's cyst is a fluid-filled sac within the Bartholin's gland of the vagina. Bartholin's cysts typically occur in nulliparous women of child-bearing age and other risk factors include a personal history of Bartholin's cyst, being sexually active, or a history of vulval surgery. Bartholin's cysts can cause vulvar pain, dyspareunia, and may rupture spontaneously, relieving pain. Treatment options include incision and drainage with placement of a Word catheter or marsupialization to prevent reaccumulation of fluid.
Hysteroscopy
This document provides information about hysteroscopy, including:
- A hysteroscope is an endoscope used to visualize the uterine cavity and perform procedures.
- It describes the historical development of hysteroscopy from the 19th century to modern techniques.
- The types of hysteroscopes and instrumentation used are outlined, including distention media, electrodes, sheaths, and cameras.
- The document discusses the procedures, indications, contraindications and complications of diagnostic and operative hysteroscopy.
Rectal prolapse.pptx
The document provides tips for using a PowerPoint presentation on rectal prolapse. It recommends:
1. Freely editing and modifying the slides and adding your name.
2. Noting that half the slides are blank except for the title to facilitate active learning sessions.
3. Showing blank slides, asking students what they know, and then showing the content slide.
4. Rerunning the show at the end to reinforce learning.
5. Using this approach for 3 revisions to optimize learning.
It also provides the presentation format and sample content slides on topics like relevant anatomy, aetiology, clinical features, and management of rectal prolapse.
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Hypertrophic elongated cervix (elongation of cervix)
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Spermatocoele
Spermatocele is a benign cystic accumulation of sperm that arises from the head of the epididymis. It typically presents as an asymptomatic mobile swelling near the testicle. Ultrasound shows a hypoechoic cystic lesion connected to the epididymis. Treatment involves observation for small asymptomatic cases or spermatocelectomy via scrotal surgery to remove the cyst. Sclerotherapy is sometimes used as an alternative but has a higher recurrence rate.
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El documento describe un caso clínico de un paciente masculino de 25 años que acude a consulta por dolor testicular izquierdo punzante de un año de evolución. La exploración física revela dilataciones venosas en el hemiescroto izquierdo, indicando la presencia de un varicocele. El varicocele se define como la dilatación de las venas del cordón espermático, lo cual ocurre más frecuentemente en el lado izquierdo debido a factores anatómicos. El varicocele puede causar daño testicular a trav
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This document discusses bilateral hydrocele, which is a fluid collection around the testes. It defines different types of hydrocele including congenital, infantile, encysted, and secondary to infections. Key features include a fluctuant, transilluminant swelling above the scrotum without palpable testes. Complications can include infection, infertility, and testicular atrophy. Differential diagnoses include hernia and tumors. Treatment involves surgical techniques like Lord's plication, evacuation and eversion, or subtotal excision depending on size and characteristics of the hydrocele sac.
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This document discusses varicoceles, which are dilated and tortuous veins in the pampiniform plexus that commonly occur in the left testicle. Varicoceles are a common cause of male infertility and are often treated with varicocelectomy surgery to ligate the veins. The document describes the anatomy, causes, symptoms, grading, investigations, and surgical and non-surgical treatment options for varicoceles.
Testicular torsion by Dr Teo
1. Orchitis and epididymo-orchitis are usually caused by blood-borne infections like Chlamydia, gonorrhea, or E. coli. They present with acute pain and swelling of the testes or epididymis.
2. Undescended testes occur in 1% of boys after 1 year of age and can lead to infertility if not treated. Risk factors include prematurity and family history. Treatment is orchidopexy to bring the testes into the scrotum.
3. Testicular torsion occurs when the spermatic cord twists, cutting off blood supply to the testes. It requires urgent surgery to untwist the cord or
Imaging of the scrotum
A 47-year-old male presented with progressive abdominal pain for 1 month. Imaging of the scrotum and testes is discussed. The document outlines anatomy, imaging modalities including ultrasound, MRI and CT. Common pathologies are discussed such as testicular masses including different types of cancers like seminoma, embryonal carcinoma, yolk sac tumor, teratoma and choriocarcinoma. Staging and tumor markers are also mentioned.
Evaluation of Testicular Pain
1. Testicular pain can be acute or chronic, with acute pain having a sudden onset and chronic pain lasting over 3 months. Common causes of acute pain include testicular torsion, trauma, strangulated inguinal hernia, and epididymitis/orchitis.
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TESTICULAR TUMOURS
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This document discusses various scrotal swellings including:
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3. The diagnosis of scrotal swellings involves assessing whether the testis and epididymis can be identified separately, if the swelling transilluminates, and if it is tender.
3 scrotal swellings
This document discusses various scrotal swellings including painful and painless conditions. Painful scrotal swellings include testicular torsion, epididymitis, hematocele, rupture testis, complicated hernia, and some testicular tumors. Painless scrotal swellings include testicular tumors, varicocele, hydrocele, spermatocele, and hernia. The document provides guidance on diagnosing scrotal swellings by assessing whether the testis and epididymis can be identified separately, if the swelling transilluminates, and if it is tender. Specific conditions are described such as hernias, hydroceles, testicular tumors, and testicular torsion
attachment(1).pptx
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Testicular torsion occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum.
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Age Testicular torsion is most common between ages 12 and 18.
Previous testicular torsion
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Disclaimer: A lot from this slides were taken also from https://www.slideshare.net/babysurgeon/scrotal-swellings-1 (Dr Selvaraj Balasubramani)
This covers only :
ANATOMY
CAUSES
TORSION OF TESTIS
EPIDIDYMO-ORCHITIS
HYDROCELE
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VARICOCELE
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Painless scrotal swelling
- 1. TT, TEO, CH & Gumma By: Ismah Haron 1
- 2. Testicular tumor • Seminoma • Teratoma • Combined • Interstitial tumors 2
- 3. History • Painless lump at private area • Testicle feel heavy (diagnostic) • Malaise, loss of weight- symptoms of metastases • Associated with incomplete descended testis 3
- 4. Examination • Swelling confined to scrotum, non tender • Spherical shape • Smooth surface • Hard in consistency • Dull on percussion • Not fluctuant, not translucent 4
- 5. Management Staging; • Ultrasound (confirm) • Tumor marker (monitoring) • CXR (mets) • Orchidectomy • CT and MRI 5
- 6. • Stage 1; testis lesion only • Stage 2; nodes below diaphragm only • Stage 3; nodes above diaphragm • Stage 4; pulmonary or hepatic mets 6
- 7. 7 Source: Bailey & Love’s Short Practice of Surgery
- 8. Teratoma • Arise from totipotent cells in rete testis • 3 layers of germ layers • Variety of cell 8
- 9. 9 Source: Bailey & Love’s Short Practice of Surgery
- 10. 10 Source: Bailey & Love’s Short Practice of Surgery
- 11. • Stage 1 - Monitor level of tumor marker & repeat CT • Stage 2-4 - Chemotherapy - Retroperitoneal lymph node dissection 11
- 12. Interstitial cells tumors • Leydig and Sertoli cells • Prepubertal; masculinises • Postpubertal; feminises • Benign • Orchidectomy 12
- 13. Tuberculous epididymo-orchitis • Lump in scrotum associated with dull, aching pain • +/- systemic or urinary symptoms of TB • Develop slowly • Blood stream or from lower urinary tract 13
- 14. Examination • Epididymis hard, knobbly, 2-3x larger • Thickened spermatic cord • Vas deferens - irregular, swollen and feel like a string of bead (diagnostic) • Secondary hydrocele • Tuberculous abscess 14
- 15. Management • Urine and semen • IVU and CXR • Treat primary focus • Anti tuberculous is less effective. So, if • No response in 2 months – epididymectomy/orchidec tomy 15
- 16. Chronic haematocele • Occur when acute episode is not treated. • Characteristic: – Hard mass – Non-tender – Not fluctuant
- 17. 17 Source: Bailey & Love’s Short Practice of Surgery
- 18. Management • Ultrasound • Orchidectomy • Testis is often compressed and relatively useless 18
- 19. Gumma • A small rubbery granuloma that is characteristic of an advanced stage of syphilis • Gummas principally form in the liver, bones, and testes but may affect any organ.
- 20. Examination • Round and hard mass • Billiard ball testis • Painless • Lump/whole organ enlargement 20
- 21. 21 Source: Browse’s Introduction to the Symptoms and Signs of Surgical Disease
- 22. 22
- 23. THANK YOU 23
Editor's Notes
- Seminoma of testis
- Distribution of mets in teratoma of the testis
- Cannonball mets from ca of testis
- Tunica vaginalis – serous membrane covering testis
- Chronic hematocele-testis has been flatten by prolonged pressure
- Hydrocele-in tunica vaginalis