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What is Abscess of Scrotum: Causes, Symptoms, Diagnosis, and Treatment

Definition and Overview

A scrotal abscess refers to the collection of pus inside the scrotum. The scrotum is the sac of skin that holds the testicles. A number of factors can cause this condition to occur. It can develop as a complication of untreated bacterial infection in the bladder or urethra. Such infection can travel to the scrotum. The condition can also be a result of sexually transmitted diseases (STDs). Examples of STDs are chlamydia and gonorrhea.

When diagnosed and treated early, the condition responds very well to available treatments. However, when left untreated or when treatment is delayed, it can lead to a number of complications. The infection can become chronic. This can cause infertility. This means that the patient’s ability to cause pregnancy is compromised.

Patients with the condition present with symptoms similar to those caused by STDs and urinary tract infection (UTI). Often, there is penile discharge, pain, and an increased urgency to urinate. The condition is treated with antibiotics. The abscess is also drained.

Causes of Condition

A scrotal abscess can be caused by a number of factors. These range from infected hair follicles to bacterial infections. Some cases occur when the pus drained in patients with appendicitis finds its way to the scrotum. The same is the case when a testicular abscess ruptures.

Patients who undergo any surgery that involves the scrotum have an increased risk of the condition. Any open wound can become a gateway for bacteria and other pathogens to enter the body. This can be prevented with the use of antibiotics. Other cases occur as a form of complication of treatment for neurogenic bladder and urethral stricture.

Certain medications can also cause infection in the scrotum. Examples are those used to treat certain types of serious arrhythmias. As mentioned above, the condition can also be caused by STDs and other infections like tuberculosis.

Key Symptoms

The key symptoms of the condition include a mass in the scrotum that can be felt with fingers. It can be accompanied by a sudden pain that radiates to the back, abdomen, or groin. Patients also report a feeling of heaviness in the scrotum. Other common symptoms are swollen or hard testicles and scrotum. The infection can lead to fever and cause the patient to urinate more often.

Who to See and Treatment Available

Patients showing signs listed above can consult a general doctor for initial assessment. They may be referred to a surgeon if a scrotal abscess is suspected.

The condition is diagnosed with a number of tests and procedures. Doctors often start with a thorough physical exam and review of the patient’s medical history. Urine tests and wound culture are also used to confirm infection. These can also determine the type of pathogen that caused the condition. An ultrasound is also often used. This is a painless imaging test that makes use of sound waves to produce pictures of structures inside the body. It is very useful in identifying the causes of infection, swelling, and pain. This can help doctors make a definitive diagnosis and rule out other medical conditions that cause the same symptoms.

Treatment of the condition requires draining the abscess. The surgeon will make an incision and open the cavities to remove the pus. This will allow the affected area to heal. If there are dead tissues (which often occurs when treatment is delayed), treatment will involve surgical exploration under general anaesthesia. All dead tissue must be removed. Patients are given broad-spectrum antibiotics to prevent infection.

Surgeons often leave the wound open until it heals. This requires proper wound care to prevent infection. This also promotes the healing of the skin and damaged structures inside the scrotum.

Bed rest is advised following surgery. It is important for the scrotum to be elevated. Patients can do so by placing a towel underneath it. Patients are also advised against having sex until they are fully recovered. They are also advised to make a follow-up within a week or two after surgery to ensure that their wound is healing properly. The surgical area is also checked for any signs of complications.

References:

  • Okwudili OA. Temporary Relocation of the Testes in Anteromedial Thigh Pouches Facilitates Delayed Primary Scrotal Wound Closure in Fournier Gangrene With Extensive Loss of Scrotal Skin-Experience With 12 Cases. Ann Plast Surg.

  • Thakur A, Buchmiller T, Hiyama D, Shaw A, Atkinson J. Scrotal abscess following appendectomy. Pediatr Surg Int. 2001 Sep. 17(7):569-71.