A Cross-Sectional Study to Assess Clinico-Epidemiological Factors, Diagnosis and Management in Patients With Acute Scrotal Conditions

Abstract

Background: Many acute scrotal conditions can present in similar way, Testicular torsion is a true surgical emergency because, the likelihood of testicular salvage decreases, as the duration of torsion increases. Other conditions that present in similar way to testicular torsion include, torsion of appendix testis, epididymo - orchitis, blunt trauma to testis, fournier's gangrene, haematocele, pyocele, etc. Aim: Assessment of clinico-epidemiological factors, diagnosis and management in patients with acute scrotal conditions. Methods: This observational, cross-sectional study was conducted on 75 patients which includes all cases of acute scrotal conditions within age group of 5 years to 70 years presenting to surgery OPD or casualty and getting admitted in a tertiary care centre in eastern part of Maharashtra during the period. Results: In our study acute epididymo-orchitis (46.7%) was the commonest cause of acute scrotal pathology followed by Fourneir's gangrene (24%).Incidence of scrotal cellulitis, pyocele, torsion testis, haematocele, were 9.3%,8%,6.7%, 2.7% respectively. One case each of testicular abscess(1.3%) and testicular tumour (1.3%) were also found. Out of 75 cases, 36 cases (48%) were managed conservatively. In Fournier's gangrene, only debridement was done in 8 cases, multiple debridement with secondary suturing was done in 5 cases, multiple debridement followed by skin grafting was done in 5 case. Scrotal exploration and drainage of testicular abscess was done in 1 case. Scrotal exploration with evacuation of hematoma was done in 2 cases of haematocele. Orchidectomy was done in total of 4 cases in which 3 cases have clinical diagnosis of testicular torsion and one case of testicular tumour. Also orchidectomy with contralateral orchidopexy was done in 2 cases of testicular torsion. Conclusion: The most common cause of acute scrotum was epididymo - orchitis which can be managed conservatively. Early exploration can salvage the testis in cases torsion of testis.