Av. Recoleta 464, Recoleta, Santiago, Chile
Fono 2 2270 2700
Clínica Alemana de Santiago
Av. Vitacura 5951, Vitacura, Santiago, Chile
Fono 2 2210 1111
Dra. Angélica Paulos
TESTICULAR AND SCROTAL CONDITIONS
Empty scrotal sac:
- Evanescent Test
- Testicular atrophy
- Exacerbated scrotal reflex
- Testicular Ectopy
- Morganni Hydtid Twist
- Twisting of the spermatic cord
- Skin lesions
- Epididymis cyst
- Testicular tumor
Nuck's or cord's cyst
Empty Scrotal Sac: Cryptorchid and others
Failure to find one or both testicles in the scrotum may be due to:
1.-Inguinal cryptorchidism: The testicles descend from the abdomen to the scrotum during pregnancy through a duct called the inguinal duct. The Cryptorchid occurs when the testis or testes are in the inguinal canal and remain there, without descending into the scrotum. The testicles do not function properly if they are exposed to higher temperatures, so it is essential, in front of the diagnosis, to descend the testicles into the scrotum.
2.- Ectopic Testicle: The testicle is outside the inguinal canal and outside the scrotum, as in the base of the penis, root of the thigh.
3.- Intrabdominal testicle: The testicle is in the abdomen and did not descend to the scrotum.
4.- Cremateric Reflex and Elevated Testicle: The ascent of the testicle from the scrotum to the inguinal canal temporarily is due to the cremasteric reflex. The contraction of the scrotal bag muscle, the cremaster muscle, is triggered by stimuli such as cold or fear and transiently ascends the testicle.
5.- Testicular Atrophy and Evanescent Testicle: Absence of testicle or lack of development of it.
All of this conditions needs to be evaluated by a pediatric surgeon, and some of the need surgery to keep save the testicle development
Acute Scrotum Syndrome
Acute scrotum syndrome presents with scrotal pain, redness (erythema), and swelling or hydrocele.
An evaluation by a pediatric surgeon allows determining the most appropriate management. Emergency surgery is the safest procedure against suspected spermatic cord torsion.
The most frequent causes are:
1.-The Hydatid or Morgagni Appendix is an embryonic remnant that can be twisted, producing an acute scrotum syndrome. When it cannot be differentiated from the Spermatic Cord Torsion or the symptoms are very intense, it should be explored surgically.
2.- Torsion of the spermatic cord: the testicle rotates and the vessels supplying the testicle are occluded, which causes the testicle to necrose. It requires urgent surgery promptly to assess the vitality of that testicle.
3.- Orchiepidimitis: inflammation usually due to viral infection of the testicle.
Mass in the scrotum should be studied promptly in order to differentiate whether it corresponds to cancer (testicular or paratesticular tumor) or other lesions.
Varicocele are tortuous veins in the scrotum and sometimes must be operated to avoid damage to the testicle.
Epididymal cyst: It is a benign cyst, which may require surgery if they are large or bothersome.
Communicating hydrocele and cord or Nuck's cyst are fluid accumulations due to persistent peritoneovaginal duct. They generally require surgery for resolution.