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A 39 year old man with the history of left UDT that he has been suffering from pain in left inguinal area specially when he sneezes or coughs since 7 days ago (prior to refer). He also complains of in      7/2/2022 1

 frequency, hematuria and terminal dribbling was negative.

He has a child. He has no other diseases and there was no important point in his drug history and habits. Also his family history was negative except for hypertension in his mother.

In his physical examination he was a middle aged man, was not ill or toxic. His blood pressure was 130/70, pulse rate was 76, respiratory rate was 17 and with oral temperature of 37 C. Examination of head & neck was not significant, examination of chest was also normal, his abdomen was normal with no scars, it was soft, no tenderness, no guarding, no organomegaly and CVA tenderness. In the examination of genitalia left testis was not palpable, left scrotum was hypoplastic and he had swelling in left inguinal but without tenderness. His right tesis, scrotum and penis was normal. He was admitted for orchiodectomy  and antibiotic was started for him and ultrasonography was performed and the left testis was seen in inguinal canal with inflammatory and high viscosity fluid around and also cystic area in left scrotum. His U/A was positive for bacteriuria, leukocyturia, proteinuria and hematuria.

During the surgery after exploration of left testis and incision of layers the fluid and tumor was seen and was sent for pathological evaluation.

 

 

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