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Showing posts with the label epididymal cyst

Lumps in the scrotum - Differential diagnosis

Inguinal hernia, hydrocele, epididymal cyst, testicular tumour, varicocele, sebaceous cyst, tuberculous epididymo-orchitis, gumma of the testis, carcinoma of scrotal skin. Determining the diagnosis Inguinal hernia An indirect inguinal hernia often extends into the scrotum. It usually has a cough impulse (i.e. it expands on coughing) and usually reduces with direct pressure or on lying down. It is not possible to get above the lump. Hydrocele A hydrocele is an abnormal quantity of peritoneal fluid between the parietal and visceral layers of the tunica vaginalis, the double layer of peritoneum surrounding the testis and which was the processus vaginalis in the fetus. Normally the processus vaginalis becomes obliterated along its entire length, apart from where it surrounds the testis where a potential space remains between the parietal and visceral layers. Usually painless, unless the underlying testicular disease is painful. A hydrocele has a smooth surface and it is difficult or im