Torsion: may cause testicular infarct if not treated quickly. This usually occurs in the first year of life or also towards puberty due to trauma . It is associated with incomplete descent, absent scrotal ligaments, absent gubernaculum testis or testicular atrophy causing the testis to be abnormally mobile. Torsion must last at least 6-24 hours to cause an infarct. Treatment consists of untwisting and fixing the testis to dartos muscle or orchidectomy. The opposite testis should be fixed to dartos muscle as a preventive measure.
Vasiitis nodosa: condition of the vas deferens, which resembles spermatic granuloma of the epididymis. It is usually post vasectomy or herniorrhaphy and occasionally associated with recanalisation. Histology shows proliferating ductules and dilated tubules containing spermatozoa in the wall of the vas deferens with hyperplastic smooth muscle. May see perineural or vascular invasion by the proliferating ductules.
Varicocele: abnormal dilation and tortuosity of veins in the pampiniform plexus of the spermatic cord probably due to insufficiency of venous valves. It is often associated with infertility. Ninety per cent are on the left and 10% bilateral. Treatment consists of ligation or occlusion of the left spermatic vein and after treatment 40-55% are fertile.
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