The Spectrum of Testicular Pathologies Upon Scrotal Exploration for Acute Scrotum: A Retrospective Analysis.

Muhammad Khalid Syed,Sabahat K Syed,Hasan Alaeddin,Talal Almas,Ahmed A Hussein,Salman Hussain,Saifullah Syed,Ahmad A Al Faqeeh,Alsayed Othman,Reema Alsufyani

doi:10.7759/cureus.10984

Abstract

BackgroundThe term acute scrotum encompasses a plethora of testicular pathologies that are detrimental to the survival and sustenance of testes. The aim of the present study is to determine the spectrum of these testicular pathologies upon scrotal exploration performed in the aftermath of acute scrotal pain in the pediatric population.MethodsThis multicenter retrospective cross-sectional study was conducted at the department of pediatric surgery at two hospitals. During the study period, the clinical characteristics of the 76 patients that underwent scrotal exploration for acute scrotum were assessed. These included age, duration of symptoms on presentation, and identification of the etiology underlying scrotal pain. The data obtained was eventually analyzed using the Statistical Package for the Social Sciences (SPSS) 23.0 software (IBM Corp., Armonk, NY).ResultsA total of 76 scrotal exploration procedures were performed. The involvement of the left side of the scrotum was more common than the right side. Most of the patients who presented were older than five years of age. A majority of the patients presented after 24 hours of the commencement of their symptoms. Of the included participants, 36 patients (47.47%) were found to have an underlying torsion of appendix testes that was appropriately managed. Testicular torsion was observed in 15 patients, out of which eight viable testes were salvaged with a subsequent orchidopexy while seven torsions required orchiectomy owing to their non-viability. Other findings included epididymo-orchitis and infected hydrocele. A total of 19 testes appeared completely normal upon scrotal exploration.ConclusionScrotal exploration should be considered as part of the medical and surgical workup and in the management of acute scrotum, as it divulges the specific underlying testicular pathology. Prompt scrotal exploration can aid in ascertaining the underlying etiology and is, therefore, pivotal in the apt management of the underlying pathology.

Highlights

Acute scrotum (AS) is a medical and surgical emergency that manifests itself in a multitude of clinical symptoms, including new-onset acute pain, swelling, and tenderness of the scrotum [1]
Testicular torsion was observed in 15 patients, out of which eight viable testes were salvaged with a subsequent orchidopexy while seven torsions required orchiectomy owing to their nonviability
A total of 19 testes appeared completely normal upon scrotal exploration

Summary

Introduction

Acute scrotum (AS) is a medical and surgical emergency that manifests itself in a multitude of clinical symptoms, including new-onset acute pain, swelling, and tenderness of the scrotum [1]. Acute scrotal pain is most often caused by TAT or TT [1]. In instances where the prompt management of TT is obtained within the first six hours of the onset of symptoms, testicular salvage rates hover around 90% to 100% [3]. The aim of the present study is to determine the spectrum of these testicular pathologies upon scrotal exploration performed in the aftermath of acute scrotal pain in the pediatric population

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Results

Discussion

Conclusion