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57 Cards in this Set
- Front
- Back
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what defines a fractured penis? |
fracture corpus cavernosum and its sheath (tunica albuginea) |
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what surrounds the urethra |
corpus spongiosum |
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what sheath surrounds the two corpus cavernosums? |
tunica albuginea |
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location frequency of prostate cancer |
peripheral zone - 70% transition zone - 20% central zone - 10% |
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prostate cancer imaging characteristics on MRI
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cancer is dark - stands out against the bright peripheral zone - will correlate with dark ADC/bright DWI |
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what is the enhancement pattern for prostate cancer? |
early enhancement and washout |
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what is the best test to look for prostate mets |
bone scan |
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what volume is defined as BPH? |
>30 cc |
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what zone is most commonly involved in BPH? |
transitional zone |
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what imaging findings of the ureter are characteristic of BPH |
"J shaped" or "fishhook" shaped |
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what is the difference in pathologenesis of prostatic utricle cyst vs mullerian duct cyst |
mullerian duct cyst is an anatomic variant of the caudal end of the mullerian duct prostatic utricle is focal dilation of the prostatic urethera |
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where do prostatic utricles and mullerian duct cysts live? |
midline cystic structure near the bladder |
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what is associated with prostatic utricle? |
-hypospadius (most commonly associated) -prune belly syndrome, downs, unilateral renal agenesis and imperforate anus |
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what is a complication of prostatic utricle? |
if large can get infected |
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what is a complication of mullerian duct cyst? |
-cancer - endometrial, clear cell and squamous (no association with congenital abnormalities like with prostatic utricle) |
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what is the location of a seminal vesicle cyst? |
unilateral and lateral to the prostate (if large can look midline) |
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what is associated with congenital seminal vesicle cysts? |
-renal agenesis -vas deferens agenesis -ectopic ureter insertion |
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what is associated with acquired seminal vesicle cysts? |
-obstruction often from BPH or chronic infection/scarring |
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when is acquired seminal vesicle cyst classically seen? |
with prior prostate surgery |
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what are the three midline male pelvic cysts? |
1. prostatic utricle 2. mullerian duct cyst 3. ejaculatory duct cyst |
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what are the two lateral male pelvic cysts |
1. seminal vesicle cyst 2. diverticulosis of the ampulla of the vas deferens |
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what is the treatment for testicular rupture? |
surgery (intratesticular fracture and hematomas do not need surgery) |
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what are the imaging characteristics of testicular rupture |
-disrupted tunica albuginia -heterogeneous testicle -poor testicular outline |
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what are the imaging characteristics of testicular fracture? |
-intact tunica albuginia -linear hypoechoic band across the parenchyma -well defined testicular outline |
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what are the three imaging characteristics of testicular torsion? |
1. absent/decreased blood flow (venous first) 2. asymmetric enlargement 3. relatively decreased echogenicity |
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what is a cause of testicular torsion? |
"bell-clapper deformity" = abnormal high attachement of the tunical vaginalis which increases testicular mobility (usually bilateral thus the other side gets orchiopexy) |
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what factors determine viability in testicular torsion? |
degree of torsion and how long it has been torsed (before 6 hours is best) |
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what is the most common cause of acute scrotal pain in adults |
epididymitis |
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what are the most common causes of epididymitis? |
chlamydia or gonorrhoeae -older men e. coli 2/2 urinary source |
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what causes isolated orchitis? |
mumps -most commonly from epididymitis (STDs or e. coli) |
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testicular mass with "onion skin" look? |
epidermoid cyst onion skin = alternating hypo and hyper ecohic rings -these are relatively hypovascular |
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what is the malignant potential of an epidermoid cyst of the testicle? |
zero |
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what is the characteristic finding of tubular ectasia of the rete testis on ultrasound? |
cystic dilation next to the mediastinum testis |
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what is the most common way testicular tumors metastasize? |
lymphatics (retroperitoneum next to the renal hilum) -exception is choriocarcinoma (its via blood) |
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what is the one testicular tumor which does not met via lymphatics |
choriocarcinoma (hematogeneous) |
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what is the most common type of testicular cancer? |
germ cell - of which seminomas make up 50% |
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what are the risk factors for testicular cancer? |
-cryptorchidism (increased risk of both) -gonadal dysgenesis -Klinefelters -trauma -orchitis -testicular microlithiasis (maybe) |
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what is the general prognosis of seminomas? |
best prognosis (good since they are most common) and very radiosensitive |
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what are the demographics of seminomas? |
white (9x higher) age around 25 *non seminomatous germ cell tumors usually happen younger |
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what is the ultrasound image of a seminoma? |
homogeneous hypoechoic round mass which replaces the testicle (MRI they look dark) |
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what are the types of non-seminomatous germ cell tumors? |
-mixed germ cell -teratomas -yold sac tumors -choriocarcinomas |
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imaging differences between seminomas and non-seminomas?
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non-seminomas are often larger and have larger calcs |
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what is the most common subtype of lymphoma that affects the testis? |
NHL *lymphomas can "hide" in the testis due to the blood barrier |
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testicle with multiple hypoechoic masses |
lymphoma |
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old man with large testicular calcs and shadowing on ultrasound |
thick burned out testicular tumor = spontaneous regression of a germ cell tumor ** viable tumor may still be present |
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testicular ultrasound: homogenous round mass with micro calcs |
seminoma |
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testicular ultrasound: cystic/solid mass with macro calcs |
mixed germ cell tumor or teratoma |
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what clinical entity can be seen with sertoli leydig tumors? |
gynecomastia |
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what syndrome is associated with sertoli leydig tumors? |
peutz jephers |
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testicular tumors with elevated bHCG |
1. seminoma 2. choriocarcinoma |
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testicular tumors with elevated AFP |
1. mixed germ cell 2. yolc sac |
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what are the obstructive causes of male infertility |
1. congenital bilateral absence of the vas deferens (CF) 2. ejaculatory duct obstruction 3. prostatic cysts |
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what are the non-obstructive causes of male infertility? |
1. varicocele 2. cryptorchidism 3. anabolic steroid use 4. ED |
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what is the most common cause of correctable infertility? |
varicocele |
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which side is unilateral varicocele most common on? |
left isolated right should make you suspect retroperitoneal process compressing the right gonadal vein |
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what population most commonly gets cryptorchidism |
premature kids (20%) |
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what two syndromes are associated with male infertility? |
Kallmans syndrome Kleinfelters |
