Evaluation of nonacute scrotal conditions in adults
- Robert C Eyre, MD
Robert C Eyre, MD
- Associate Professor of Surgery
- Harvard Medical School
The spectrum of conditions that affect the scrotum and its contents ranges from incidental findings that require patient reassurance to acute pathologic events that necessitate expeditious diagnosis and treatment. This topic reviews the conditions that a clinician is likely to encounter on routine physical examination. The most common nonacute scrotal conditions include varicocele, hydrocele, epididymal cyst and spermatocele, testicular cancer, chronic epididymitis, and cryptorchidism.
Acute scrotal pain in adults and scrotal disorders in children are discussed separately. (See "Evaluation of the acute scrotum in adults" and "Evaluation of scrotal pain or swelling in children and adolescents".)
The testis, tunica vaginalis, epididymis, spermatic cord, and appendix testis are anatomic structures that may be involved in nonacute scrotal conditions (figure 1):
●The testis (testicle) is the male gonad responsible for production of sperm and androgens (primarily testosterone). The normal testis is ovoid, about 3 to 5 cm in length, and firm with smooth surfaces. One testis may be slightly larger than the other, and one testis (usually the left) may hang slightly lower.
●The tunica vaginalis is a potential space that encompasses the anterior two-thirds of the testis. Different types of fluid may accumulate within the tunica vaginalis (eg, water with a hydrocele, blood with a hematocele, pus with a pyocele).
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