Diagnosis and management of a scrotal wall mass with the aid of a Scrotoscope: a descriptive observational study

Ruochen Zhang ,Liefu Ye ,Tao Li ,Yunliang Gao ,Yongbao Wei ,Qingguo Zhu ,Jinrui Yang

doi:10.31083/jomh.2021.046

Abstract

Background and objective: A scrotal wall mass is relatively rare in clinical practice, and very diﬃcult to differentiate from a scrotal content lesion by a physical or ultrasound examination. In this study, we share our experience with the scrotoscope for diagnosing and treating scrotal wall masses. Methods: We retrospectively reviewed all clinical data of scrotal wall mass patients treated by our medical team between June 2015 and July 2019. Diagnostic value was evaluated by comparison with a Doppler ultrasound examination and therapeutic value was evaluated by comparison with traditional surgery. Suspected scrotal tuberculosis or malignant scrotal tumor patients were excluded. Results: Six patients with scrotal wall masses were diagnosed and treated with the scrotoscope. A preoperative ultrasound examination led to an ambiguous or incorrect diagnosis for the origin of the scrotal wall masses in all six cases. The location of all of the masses was conﬁrmed by exploring with the scrotoscope. Three patients were diagnosed with scrotal wall cysts, and one was successfully resected during the procedure; the other two were resected through a small incision. Four scrotal wall solid masses were resected in the other three patients through small incisions after the diagnosis using the scrotoscope. No wound infection, scrotal edema, hematoma, chronic scrotal pain, or injury to the testicles or epididymis were observed. Conclusions: Scrotal wall masses are relatively rare, and it was very diﬃcult to obtain a ﬁrm diagnosis of their origin using preoperative ultrasound. The scrotoscope conﬁrmed localization of the tumor, and provided us important information for a minimally invasive resection. Endoscopic resection of a mass can be performed using a scrotoscope.

Highlights

The scrotal wall is involved in various primary and secondary pathological processes, which can lead to a variety of lesions
A scrotal wall mass is relatively rare in clinical practice, and is very difficult to differentiate from a scrotal content lesion by physical, ultrasound, or CT and MRI examinations owing to the complex structure and relatively tight space within the scrotum
Patients diagnosed with a scrotal wall mass with the aid of the scrotoscope were selected for further study

Summary

Introduction

The scrotal wall is involved in various primary and secondary pathological processes, which can lead to a variety of lesions. An ultrasound examination is usually the first choice in patients with a scrotal mass and is frequently able to provide a firm diagnosis. A scrotal wall mass is relatively rare in clinical practice, and is very difficult to differentiate from a scrotal content lesion by physical, ultrasound, or CT and MRI examinations owing to the complex structure and relatively tight space within the scrotum. A scrotal wall mass is relatively rare in clinical practice, and very difficult to differentiate from a scrotal content lesion by a physical or ultrasound examination. Four scrotal wall solid masses were resected in the other three patients through small incisions after the diagnosis using the scrotoscope. Conclusions: Scrotal wall masses are relatively rare, and it was very difficult to obtain a firm diagnosis of their origin using preoperative ultrasound. Endoscopic resection of a mass can be performed using a scrotoscope

Methods

Results

Discussion

Conclusion