Acute Scrotum in Children: A Retrospective Study of Cases With Review of Literature

Abstract

Background: Testicular pain or swelling, often referred to as acute scrotum, can have a number of causes and presentations. Testicular torsion is an emergency condition requiring early diagnosis and surgery to salvage the involved testis in order to preserve testicular fertility. The study is aimed to know the incidence, aetiology, and management of acute scrotal conditions with a particular focus on testicular torsion. Epididymorchitis, trauma, and scrotal cellulitis are other causes of acute scrotum which are managed conservatively after proper investigations.Material and methods: The authors retrospectively reviewed 10-year epidemiological data of all children age under 14 years admitted to the tertiary care hospital with the diagnosis of acute scrotum. Data were collected about the clinical history, physical examination, biochemical investigations, Doppler ultrasound, and management done.Results: 133 children aged between 0 days and 14 years (mean age, 7.5 years) were found to have acute scrotum out of which 67 (50.37%) patients had epididymitis, 54 (40.60%) patients presented with Torsion testis, three (2.25%) had torsion of testicular appendages, eight (6.01%) had scrotal cellulitis and one (0.75%) presented with a strangulated hernia. Due to late presentation, testis could be salvaged in only eight of the 54 patients with torsion testis. The testicular loss was seen more in bigger children and those with signs of infection in blood reports and colour Doppler showing no blood flow in the testis. Conclusion:The study results indicate that non-recognition of the severity of paediatric acute scrotum results in late presentation leading to testicular loss. Timely diagnosis will require sensitization of the parents, primary care providers, and paediatricians for this grave condition which leads to permanent testicular loss.

Patient Query in Adolescent Testicular Torsion Cases: "Was it Necessary to Mention My Scrotal Pain?"

“…It is evident that the general awareness of TT is deficient, with most individuals unaware that TT can occur, potentially leading to testicular loss. This deficiency in awareness appears to be true for all levels of society and educational ability, as in our patients' families [5,8,[15][16][17][18]. In comparison to families whose children underwent surgery for other reasons, our families demonstrated erratic behavior when confronted with the possibility of testicular loss due to delay.…”

Assessment of the Psychological State of Patients of Childhood Age With Testicular Torsion and Psychological Correction of Its Disorders

“…Успішне лікування дітей з перекрутом яєчка вимагає наявності фахівців з різних галузей знань. Хвилювання, що часто присутнє у пацієнтів з перекрутом яєчка та у їх батьків, стосується можливої фертильності, тому вірна лікувальна тактика з повноцінною психологічною допомогою має суттєво полегшити стан дитини і зменшити побоювання щодо здоров'я та подальшого життя [16,17]. Наявність хірургічної патології у підлітків стає додатковим психотравмуючим фактором, який є дуже стресовим для дітей та призводить до зниження самооцінки, викликає фрустрацію, що може проявлятися різноманітними дисфункціональними реакціями.…”