Scrotal mass medical therapy: Difference between revisions

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{{Scrotal mass}}
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==Overview==
==Overview==
Depend on the cause of testicular mass, treatment is differ.
Depend on the cause of testicular mass, treatment is differ.There is no treatment for tortion of testicular appendage ; the mainstay of therapy is supportive care,like using NSAID and bed rest.Testicular tortion is a medical emergency and requires prompt treatment.The mainstay of treatment for testicular cancer is radical orchectomy.The second therapy for testicular cancer depends on the stage and microscopic diagnosis.Empiric therapy for  epididymitis depends on patient`s age.Depends on the amount of fluid , treatment of hydrocele is vary from pharmochological to surgery.
There is no treatment for tortion of testicular appendage ; the mainstay of therapy is supportive care,like using NSAID and bed rest.


Testicular tortion is a medical emergency and requires prompt treatment.
==Medical Therapy==
 
*Pharmacologic medical therapies for tortion of tessticular appendage include  NSAID and bed rest.<ref name="pmid26757064">{{cite journal| author=OʼReilly P, Le J, Sinyavskaya A, Mandel ED| title=Evaluating scrotal masses. | journal=JAAPA | year= 2016 | volume= 29 | issue= 2 | pages= 26-32 | pmid=26757064 | doi=10.1097/01.JAA.0000476208.04443.ca | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26757064 }} </ref>
 
*Empiric therapy for epididymitis depends on patient`s age .<ref name="pmid26757064">{{cite journal| author=OʼReilly P, Le J, Sinyavskaya A, Mandel ED| title=Evaluating scrotal masses. | journal=JAAPA | year= 2016 | volume= 29 | issue= 2 | pages= 26-32 | pmid=26757064 | doi=10.1097/01.JAA.0000476208.04443.ca | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26757064  }} </ref>
The mainstay of treatment for testicular cancer is radical orchectomy.
   
The second therapy for testicular cancer depends on the stage and microscopic diagnosis.


Empiric therapy for  epididymitis depends on patient`s age.
Depends on the amount of fluid , treatment of hydrocele is vary from pharmochological to surgery.
==Medical Therapy==
*Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
*Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
*Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
*Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].
===Disease Name===
===Disease Name===
 
* '''Epididymitis'''
* '''1 Stage 1 - Name of stage'''
Patients 14-35 yearrs old :
** 1.1 '''Specific Organ system involved 1'''
*Ceftriaxon 250mg single dose intramusculary, and
*** 1.1.1 '''Adult'''
*Doxycycline 100mg orally twice daily for 10 days, Or
**** Preferred regimen (1): [[drug name]] 100 mg PO q12h for 10-21 days '''(Contraindications/specific instructions)'''  
*Azithromycine 1gr single dose orally
**** Preferred regimen (2): [[drug name]] 500 mg PO q8h for 14-21 days
patients younger than 14 or older than 34 , or patients is allergic to cephalosporins or tetracyclines :
**** Preferred regimen (3): [[drug name]] 500 mg q12h for 14-21 days
*Ofloxacin 300mg orally twice daily for 10 days, or
**** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days  
*Levofloxacin 500mg orally once daily for 10 days.<ref name="pmid19378875">{{cite journal| author=Trojian TH, Lishnak TS, Heiman D| title=Epididymitis and orchitis: an overview. | journal=Am Fam Physician | year= 2009 | volume= 79 | issue= 7 | pages= 583-7 | pmid=19378875 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19378875 }} </ref>
**** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
**** Alternative regimen (3): [[drug name]] 500 mg PO q6h for 14–21 days
*** 1.1.2 '''Pediatric'''
**** 1.1.2.1 (Specific population e.g. '''children < 8 years of age''')
***** Preferred regimen (1): [[drug name]] 50 mg/kg PO per day q8h (maximum, 500 mg per dose) 
***** Preferred regimen (2): [[drug name]] 30 mg/kg PO per day in 2 divided doses (maximum, 500 mg per dose)
***** Alternative regimen (1): [[drug name]]10 mg/kg PO q6h (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
****1.1.2.2 (Specific population e.g. '<nowiki/>'''''children < 8 years of age'''''')
***** Preferred regimen (1): [[drug name]] 4 mg/kg/day PO q12h（maximum, 100 mg per dose）
***** Alternative regimen (1): [[drug name]] 10 mg/kg PO q6h (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose) 
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
** 1.2 '''Specific Organ system involved 2'''
*** 1.2.1 '''Adult'''
**** Preferred regimen (1): [[drug name]] 500 mg PO q8h
*** 1.2.2  '''Pediatric'''
**** Preferred regimen (1): [[drug name]] 50 mg/kg/day PO q8h (maximum, 500 mg per dose)
 
* 2 '''Stage 2 - Name of stage'''
** 2.1 '''Specific Organ system involved 1 '''
**: '''Note (1):'''
**: '''Note (2)''':
**: '''Note (3):'''
*** 2.1.1 '''Adult'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
**** Oral regimen
***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days 
***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
*** 2.1.2 '''Pediatric'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
***** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day) '<nowiki/>'''''(Contraindications/specific instructions)''''''
**** Oral regimen
***** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Preferred regimen (2): [[drug name]] '''(for children aged ≥ 8 years)''' 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Alternative regimen (1):  [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days  (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days  (maximum,500 mg per dose)
** 2.2  '<nowiki/>'''''Other Organ system involved 2''''''
**: '''Note (1):'''
**: '''Note (2)''':
**: '''Note (3):'''
*** 2.2.1 '''Adult'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
**** Oral regimen
***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days 
***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
*** 2.2.2 '''Pediatric'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
***** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day)
**** Oral regimen
***** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Preferred regimen (2): [[drug name]] 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Alternative regimen (1):  [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days  (maximum,500 mg per dose)


==References==
==References==

Latest revision as of 16:42, 17 December 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Niloofarsadaat Eshaghhosseiny, MD[2]

Overview

Depend on the cause of testicular mass, treatment is differ.There is no treatment for tortion of testicular appendage ; the mainstay of therapy is supportive care,like using NSAID and bed rest.Testicular tortion is a medical emergency and requires prompt treatment.The mainstay of treatment for testicular cancer is radical orchectomy.The second therapy for testicular cancer depends on the stage and microscopic diagnosis.Empiric therapy for epididymitis depends on patient`s age.Depends on the amount of fluid , treatment of hydrocele is vary from pharmochological to surgery.

Medical Therapy

  • Pharmacologic medical therapies for tortion of tessticular appendage include NSAID and bed rest.[1]
  • Empiric therapy for epididymitis depends on patient`s age .[1]

Disease Name

  • Epididymitis

Patients 14-35 yearrs old :

  • Ceftriaxon 250mg single dose intramusculary, and
  • Doxycycline 100mg orally twice daily for 10 days, Or
  • Azithromycine 1gr single dose orally

patients younger than 14 or older than 34 , or patients is allergic to cephalosporins or tetracyclines :

  • Ofloxacin 300mg orally twice daily for 10 days, or
  • Levofloxacin 500mg orally once daily for 10 days.[2]

References

  1. ↑ 1.0 1.1 OʼReilly P, Le J, Sinyavskaya A, Mandel ED (2016). "Evaluating scrotal masses". JAAPA. 29 (2): 26–32. doi:10.1097/01.JAA.0000476208.04443.ca. PMID 26757064.
  2. ↑ Trojian TH, Lishnak TS, Heiman D (2009). "Epididymitis and orchitis: an overview". Am Fam Physician. 79 (7): 583–7. PMID 19378875.

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