Evaluation of the acute scrotum 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 merely require patient reassurance to acute pathologic events that require immediate surgical intervention.
This topic reviews the clinical evaluation and management of the acute scrotum. Nonacute scrotal pathology in adults and scrotal disorders in children are discussed in detail separately. (See "Evaluation of nonacute scrotal conditions in adults" and "Evaluation of scrotal pain or swelling in children and adolescents".)
The testis, tunica vaginalis, epididymis, spermatic cord, and appendix testis are important anatomic structures that may be involved in acute scrotal pathology (figure 1):
●The testis or testicle is the male gonad responsible for production of sperm and androgens, primarily testosterone.
●The tunica vaginalis is a potential space that encompasses the anterior two-thirds of the testicle. Different types of fluid may accumulate within the tunica vaginalis (ie, water in hydrocele, blood in hematocele, and pus in pyocele).
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- NORMAL ANATOMY
- DIFFERENTIAL DIAGNOSIS
- Testicular torsion
- - Clinical features and diagnosis
- - Treatment
- Manual detorsion
- - Infectious
- Clinical features and diagnosis
- - Noninfectious
- Fournier's gangrene
- - Clinical features and diagnosis
- - Treatment
- Other causes
- - Torsion of the appendix testis
- - Trauma
- - Post-vasectomy
- - Testicular cancer
- - Inguinal hernia
- - Henoch-Schönlein purpura (IgA vasculitis)
- - Mumps
- - Referred pain
- - Acute idiopathic scrotal edema
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS