This document discusses testicular varicoceles, which are abnormal dilations of the veins within the pampiniform plexus that surrounds the testicles. Varicoceles are found in approximately 15% of men and can cause scrotal pain or swelling. Ultrasound is the most common imaging method used to diagnose varicoceles by identifying dilated veins in the pampiniform plexus that enlarge further with maneuvers like Valsalva. Treatment options include percutaneous embolization to occlude the spermatic vein by catheterization or surgical ligation of the vein through sub-inguinal, inguinal, or retroperitoneal approaches.
Made by Ranjith R Thampi. A surgery powerpoint I made during internship for Management of Varicose Veins. Tried to cover as much as possible on the topic. Kindly comment before you download. Thanks!
Made by Ranjith R Thampi. A surgery powerpoint I made during internship for Management of Varicose Veins. Tried to cover as much as possible on the topic. Kindly comment before you download. Thanks!
URETHRAL INJURY- Trauma Surgery
#surgicaleducator #babysurgeon
Dear viewers,
Greetings from “Surgical Educator”
Today I have uploaded a video on URETHRAL INJURY- one more in Trauma Surgery. I haven’t talked elaborately but have included the essential minimum an undergraduate medical student should know. I have talked about anatomy, classification, etio-pathogenesis, symptoms, signs, investigations, grading, treatment, complications, treatment algorithm and case vignettes of urethral injuries. My aim is, after watching this video all of you should be able to arrive at a correct working diagnosis of the type of urethral injury and should also be able to institute immediate treatment to the patients if there is a need. The definitive urethroplasty should be done by a Urologist. You can watch the video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video.
Types of Urethral injury, Mechanism of Urethral injury, Classification of Urethral injury, Symptoms of Urethral injury, Signs of Urethral injury,
Investigations for Urethral injury, Grading of Urethral Injury, Treatment for Urethral injury, Complications of Urethral Injury
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
EPIDIDYMAL CYST
VARICOCELE
Drenaje venoso testicular, fisiopatologia, clasificacion, ultrasonido escrotal con flujo Doppler, infertilidad, indicacion quirurgica, abordaje retroperitoneal vs inguinal vs subinguinal vs laparoscopico, resultados y complicaciones quirurgicas
URETHRAL INJURY- Trauma Surgery
#surgicaleducator #babysurgeon
Dear viewers,
Greetings from “Surgical Educator”
Today I have uploaded a video on URETHRAL INJURY- one more in Trauma Surgery. I haven’t talked elaborately but have included the essential minimum an undergraduate medical student should know. I have talked about anatomy, classification, etio-pathogenesis, symptoms, signs, investigations, grading, treatment, complications, treatment algorithm and case vignettes of urethral injuries. My aim is, after watching this video all of you should be able to arrive at a correct working diagnosis of the type of urethral injury and should also be able to institute immediate treatment to the patients if there is a need. The definitive urethroplasty should be done by a Urologist. You can watch the video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video.
Types of Urethral injury, Mechanism of Urethral injury, Classification of Urethral injury, Symptoms of Urethral injury, Signs of Urethral injury,
Investigations for Urethral injury, Grading of Urethral Injury, Treatment for Urethral injury, Complications of Urethral Injury
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
EPIDIDYMAL CYST
VARICOCELE
Drenaje venoso testicular, fisiopatologia, clasificacion, ultrasonido escrotal con flujo Doppler, infertilidad, indicacion quirurgica, abordaje retroperitoneal vs inguinal vs subinguinal vs laparoscopico, resultados y complicaciones quirurgicas
Actinic keratoses: Erythematous scaly lesions on sun-damaged skin & considered “precancerous” lesions that have the potential to progress into invasive SCC.
Bowen’s disease: SCC in situ It has the potential to progress to invasive SCC.
Leukoplakia: Leukoplakia refers to a white patch or plaque on the oral mucosa that cannot be wiped off and cannot be characterized clinically or pathologically as any other disease.
Hinduja Hospital Webinar on Understanding Undescended TestisHinduja Hospital
Hinduja hospital conducts regular webinars and tweetinars to help online users get medical advice from expert doctors of hinduja hospital. A similar webinar was conducted by hinduja hospital on undescended testis under guidance of Dr. Rasik Shah.
Have you observed a testicular deformation in your infant that doesn't correct itself? Do you know the common problem for which child may need surgery that is related with the descent and final position of testis? Approximately 1% of the children needs surgery for abnormal location of the testis.
To know more about Reproductive Deformities in Male Child and its treatment join talk by our expert in Pediatric Surgeon.
To know about upcoming webinars sign up at http://www.hindujahospital.com/communityportal/webinar/
Opthalmology in the ED - Dr Andrew White (June 2013)Bishan Rajapakse
This comprehensive overview of common ophthalmological presentations that ED registrars may encounter has been kindly shared by Dr Andrew White BMedSci(hons) MBBS PhD FRANZCO, Consultant Ophthalmologist, Westmead Hospital & Sydney Medical School (USyd)
uses and indication of radiology in surgeryanimesh kunwar
1.Introduction
2.Diagnostic modalities in radiology
3.Role of radiological imaging in emergency surgical situation
4.Role of radiological imaging in elective surgical situation
5.Conclusion
2. • A varicocele is an abnormal degree of venous
dilatation in the pampiniform plexus.
• It affects approximately 15% of men. It can
present with scrotal pain and swelling, or
during the investigation of male sub-fertility.
• Nowadays most are detected incidentally in
patients undergoing scrotal ultrasound for
other reasons and remain clinically silent.
3. • The aetiology of varicoceles is unclear.
• Idiopathic varicoceles are more common on the
left side where the left spermatic vein enters
perpendicular to the left renal vein. The right
spermatic vein enters obliquely into the inferior
vena cava and this appears to have some
protective effect on the right side.
• Retrograde flow into the internal spermatic vein
results in dilatation and tortuosity of the
pampiniform plexus.
4. Diagnosis
Clinical
• Varicoceles may be symptomatic with pain and
swelling.
• A Valsalva manoeuvre (expiration against a closed
glottis) is an important part of the clinical
examination as this causes distension of the
pampiniform plexus allowing greater
visualization. Varicoceles greater than 3–4 mm in
diameter are usually clinically apparent.
• A large varicocele is often described as a bag of
worms surrounding the testis
5. clinical grading system for
palpable varicoceles.
• Grade 1 varicoceles are considered to be
those palpable only during a Valsalva
manoeuvre.
• Grade 2 varicoceles are palpable without the
Valsalva manoeuvre.
• Grade 3 varicoceles are visible on examination
before palpation.
6. Imaging
• Ultrasound is now the most frequently used
method and a high-frequency transducer of at
least 7 MHz should be used. The features on
grey scale ultrasound include a prominence of
at least two to three veins of the pampiniform
plexus, of which one should have a diameter
greater than 2–3 mm in a supine position.
7. Figure 1 (a) Grey scale ultrasound demonstrates large
varicocele surrounding the right testes.
8. (b) Coronal
gadolinium-enhanced coronal fast low angle shot
(FLASH) MRI image demonstrates large right renal mass
with ipsilateral varices.
9. Imaging techniques used in evaluating
testicular varicoceles
Imaging method Diagnostic criteria
Ultrasound Tortuous anechoic tubular structures adjacent to the testis. R2
prominent veins in pampiniform plexus. Expand with Valsalva
manoeuvre and upright position with at least one > 2–3 mm in
diameter
Colour Doppler Reflux in the spermatic vein, which increases with Valsalva
manoeuvre, may be identified.
Doppler sonography can be used to grade venous reflux as static
(grade I), intermittent (grade
II), or continuous (grade III)
10. Venography Enlargement of internal spermatic vein with reflux into the
abdominal, inguinal, scrotal or pelvic portions of the spermatic
vein. Venous collateralization present. Incompetent spermatic
vein
MRI Gadolinium-enhanced imaging useful. Delayed imaging in
venous phase identifies mass of dilated vessels and prominence
of the pampiniform plexus
Scintigraphy Static images show intra-scrotal accumulation of the labelled
(technetium- red cells. Supine and erect
99mlabelled imaging is obtained. Reflux may be shown on dynamic images
red blood cells)
11. • Colour Doppler has been shown to improve
diagnostic ability by the detection of reverse
flow in the incompetent vein. The reflux is
quantified as permanent, which is significant
for a varicocele; intermittent; or brief, which is
physiological. Intermittent reflux is an area of
debate and is usually insignificant if there is no
palpable varicocele.
12. (a) There is a varicocele on the left side of
the pampiniform plexus.
13. (b) After Valsalva manoeuvre there is marked engorgement and prominence
of the varicocele.Initially the patient is in the supine position and
then erect. Valsalva is attempted in both.
14.
15. • venography is still considered to be the gold
standard, it is time consuming and invasive.
• If a varicocele is present, the internal
spermatic vein will be enlarged and there will
be reflux into the abdominal, inguinal, scrotal
or pelvic portions of the spermatic vein. There
will also be venous collateralization and
anastomotic channels.
16. • The degree of reflux on venography from 0 to
5.
• Grade 0 was no reflux, grade 1 to 5
represented reflux into the upper lumbar,
lower lumbar, upper pelvic, lower pelvic or
inguinal portions of the spermatic veins,
respectively
17.
18.
19. • Imaging with other techniques, such as magnetic
resonance imaging (MRI) or computed
tomography (CT), is only occasionally required,
for example, to evaluate the presence of
obstructing masses particularly on the right side.
• When conventional venography is
contraindicated (history of anaphylaxis, etc),
magnetic resonance venography (MRV) is a
suitable alternative (Fig. 6).
• Magnetic resonance angiography has been used
for the assessment of recurrent varicoceles
20.
21.
22. • the choice is between surgical treatment and
radiological treatment.
• Where there is a trained radiologist,
percutaneous embolization should be the first-
line therapy, with surgery reserved for the small
proportion of patients who have failed
catheterization
23. • Percutaneous embolization involves selective
catheterization of the spermatic vein and
subsequent occlusion with a sclerosing agent
or a solid embolization coil.
• With surgery, three common techniques are
employed. These are sub-inguinal ligation,
inguinal ligation and retroperitoneal ligation,
with the latter being the most frequently
practiced