{"id":13760,"date":"2023-10-25T14:38:18","date_gmt":"2023-10-25T14:38:18","guid":{"rendered":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/?p=13760"},"modified":"2023-10-25T14:38:22","modified_gmt":"2023-10-25T14:38:22","slug":"llr-asymptomatic-scrotal-swelling-varicocele","status":"publish","type":"post","link":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/llr-asymptomatic-scrotal-swelling-varicocele\/","title":{"rendered":"LLR Bezobjawowy obrz\u0119k moszny (\u017cylaki powr\u00f3zka nasiennego)"},"content":{"rendered":"

<\/p>\n\n\n\n

Kategoria<\/strong><\/p>\n\n\n\n

Kryteria progowe<\/p>\n\n\n\n

Bezobjawowy obrz\u0119k moszny to przypadkowe wykrycie obrz\u0119ku lub guzka, kt\u00f3remu mo\u017ce towarzyszy\u0107 niewielki dyskomfort. Polityka ta nie obejmuje wszystkich ostrych i bolesnych obrz\u0119k\u00f3w moszny oraz przepuklin pachwinowych\/mosznowych.<\/p>\n\n\n\n

Uprawnienia<\/strong><\/p>\n\n\n\n

LLR ICB b\u0119dzie wspiera\u0107 skierowania i leczenie w nast\u0119puj\u0105cych przypadkach:<\/strong>
\u00a0<\/strong>
Podstawowa opieka<\/strong> Wspomina\u0107:<\/strong>
\u00a0
\u2013 Bolesne \u017cylaki powr\u00f3zkowe wp\u0142ywaj\u0105ce na jako\u015b\u0107 \u017cycia
\u00a0
\u2013 dzieci do lat 16 do poradni chirurgii dzieci\u0119cej
\u00a0
\u00a0 \u2013 wszystkie niepewne obrz\u0119ki moszny podda\u0107 rutynowemu USS i poczeka\u0107 na wyniki przed skierowaniem
\u00a0
Nast\u0119puj\u0105ce USS:

\u00b7 w przypadku podejrzenia nowotworu z\u0142o\u015bliwego skierowa\u0107 na 2 tygodnie do urologii

\u00b7 uspok\u00f3j pacjent\u00f3w z Hydrocoele\/Varicocoele\/torbiel\u0105 naj\u0105drza

\u00b7 Nale\u017cy rozwa\u017cy\u0107 powt\u00f3rzenie USS tylko w przypadku znacz\u0105cych zmian klinicznych

\u00b7 pacjent\u00f3w nale\u017cy kierowa\u0107 do odpowiednich informacji uzupe\u0142niaj\u0105cych, np. NHS Choices, pacjent.co.uk

\u00a0<\/strong>
Opieka dodatkowa<\/strong>
\u00a0<\/strong>
Varicocoeles u doros\u0142ych, kt\u00f3rzy przeszli leczenie w ramach podstawowej opieki zdrowotnej opisane powy\u017cej:
\u00a0
\u00b7 rozwa\u017cy\u0107 embolizacj\u0119 u m\u0119\u017cczyzn, kt\u00f3rzy maj\u0105 trudno\u015bci z zaj\u015bciem w ci\u0105\u017c\u0119 przy obni\u017conych parametrach nasienia
\u00a0
Jednak\u017ce zabiegi na \u017cylaki powszednie nie s\u0105 rutynowo zalecane w leczeniu niep\u0142odno\u015bci u doros\u0142ych, poniewa\u017c nie poprawiaj\u0105 cz\u0119sto\u015bci ci\u0105\u017c
\u00a0
\u00a0
\u017bylaki u m\u0142odzie\u017cy: z ipsilateralnym zmniejszeniem wielko\u015bci j\u0105der
\u00a0
\u00a0Jednak \u017cylaki staj\u0105 si\u0119 cz\u0119stsze na pocz\u0105tku okresu dojrzewania. Problemy z p\u0142odno\u015bci\u0105 pojawi\u0105 si\u0119 u oko\u0142o 20% dotkni\u0119tych nastolatk\u00f3w. Embolizacja \u017cylak\u00f3w jest wskazana u pacjent\u00f3w z ma\u0142ym j\u0105drem (zatrzymanie wzrostu), poniewa\u017c donoszono o nadrabianiu zaleg\u0142o\u015bci w j\u0105drach i poprawie parametr\u00f3w nasienia<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Przewodnictwo<\/strong><\/p>\n\n\n\n

Przewodnik uruchomienia: Bezobjawowy obrz\u0119k moszny, BAUS, 2013
\u00a0
Scenariusz: Zarz\u0105dzanie | Zarz\u0105dzanie | \u017bylaki | CKS | \u0141ADNY<\/a><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
Data przegl\u0105du ARP 86: 2026 r<\/td><\/tr><\/tbody><\/table><\/figure>","protected":false},"excerpt":{"rendered":"

Category Threshold Criteria Asymptomatic scrotal swelling is the incidental finding of a swelling or lump that may be associated with minor discomfort. 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