Family Nurse Practitioner Exam

In a male patient, what scrotal finding is often described as a 'bag of worms'?

1. Chronic orchitis

2. Chronic epididymitis

3. Testicular torsion

4. Varicocele

The correct answer is: Varicocele

A varicocele is often described as a "bag of worms" due to its characteristic appearance. This condition occurs when the veins within the scrotum become enlarged and are dilated, similar to a cluster of worms. On physical examination, the affected area can feel like multiple soft and twisted veins, which is the result of venous congestion. Varicoceles typically develop over time and can lead to issues such as infertility due to impaired spermatogenesis or hormonal imbalance. It's important to recognize this condition during examination, as it is one of the more common causes of male infertility and can sometimes be asymptomatic. In contrast, chronic orchitis and chronic epididymitis might exhibit swelling and tenderness but do not present with the same varicosity appearance. Testicular torsion presents as an acute medical emergency, with the affected testis being extremely painful and often raised, which also does not resemble the "bag of worms" description. Recognizing the distinct features of a varicocele helps in proper diagnosis and subsequent management.