Abnormal findings

Hyposptidius is a developmental abnormality of the penis in which there is incomplete development of the underside of the penis with an abnormal urethral orifice. Ulcerative mucosal lesions of the penis include herpes simplex, syphilis or squamous carcinoma. More rarely, they may be a feature of systemic disorders such as Reiter's syndrome or Behcet's syndrome. Non-ulcerating lesions include viral warts and infection of the prepuce (balanitis I. Any evidence of urethral discharge should be noted and sampling performed for microscopy and culture.

Figure 5.19 shows some common abnormalities of the scrotum. A hydrocele is a relatively common swelling due to accumulation of fluid in the tunica vaginalis, l! may be unilateral or bilateral. The fluid nature of the contents should he confirmed hy transillumination. The possibility that a hydrocele may obscure a testicular tumour should not be overlooked and careful palpation of both testes is therefore necessary. Infections which affect the testis specifically (,orchitis) are mumps and syphilis. The epididymis may contain a spermatocele or other cyst. It Is prone to infection. often in association with urinary tract infection. Tills may be bacterial - usually due to coliform organisms - or tuberculosis. which produces a characteristic nodular change within the epididymis accompanied by thickening of the cord. Sometimes infection involves both the testes and the epididymis, and is known as epklidymo-orchitis. Palpable varicosity of the spermatic vein (varicocele) can cause chronic local discomfort. Shortening of the spermatic cord is a characteristic of torsion of the testis.

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