Abnormal Finding
Whenever a mass is palpable you need to ellicit fluctuation and transilluminate.
- Fluctuation
- Cystic, fluid filled masses fluctuate. Fluctuation is ellicited by holding the mass firmly with thumb and two fingers of both hands. Firmly press the mass with one finger while observing for displacement of the other finger.
- Transillumination
- In a dark room, shine flashlight behind scrotum through the mass. There will be a red glow if the mass is transilluminant.
- Scrotal size and symmetry
- Large
- Hernia: palpable above the testis. Often reducible. Bowel sounds audible.
- Bilateral hydrocele
- Edema (CHF, Hepatic,Renal)
- Filariasis
- Small:
- Atrophic testis
- Cryptorchidism
- Skin
- Firm, yellowish, non-tender cysts. (Sebaceous cyst)
- Ulcerations
- Thick, indurated skin. (Filariasis)
- Testicles
- Right testis lower: (Dextrocardia)
- Mass surrounding Testicle: Cystic, fluctuating, transilluminant swelling. (
Hydrocele)
- Hard mass or nodule with loss of testicular sense. (Cancer)
- Bilateral acute tender swelling. (Mumps orchitis)
- Unilateral swollen tender erythematous (Torsion)
- Absent. (Cryptorchidism)
- Small, soft atrophic. (Aging, Hypopit)
- Epididymis
- Swollen,firm, irregular beady thickening. (Tb)
- Epidydimo-Orchitis: Testis and epidydimis can become one mass.
- Tender swollen firm. (Acute epididymitis)
- Spermatic cord
- Mass above the testicle: Painless movable cystic transilluminant mass. (Spermatocele)
- Soft bag of worms feeling, collapsing in supine position. Varicocele is a dilated mass of veins. Increase in size with Valsalva maneuvere. They feel like a "bag of worms". They disappear on supine position unless caused by retroperitoneal tumor.
- Hernia: