A Study of Acute Scrotum and its Management at a Tertiary Care Hospital: A Prospective Study

Author(s): K. Vamseedhar, N. V. Ramanaiah, K. Vasavya Umapathi, Vulchi Sree Rama Raju, E. Ganesh Reddy, Singal Reddy Hari Haranath, Dintyala Venkata S. S. Mythri

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, trauma to testis, haematocele, strangulated inguinal hernia. METHODS This is a prospective study conducted at SVRRGGH, Tirupati for a period of 12 months and 100 patients satisfying the inclusion criteria were included in the study. RESULTS In present study, the most common condition is epididymo-orchitis (35%) followed by Fournier’s gangrene (30%), pyocele (16%), haematoma (10%), torsion (8%) and scrotal wall abscess (1%). Doppler vascularity was absent in all case of torsion (100%) and increased in all cases of epididymo-orchitis (100%). All cases of epididymo-orchitis were treated conservatively. All cases of Fournier's gangrene underwent debridement. 8 cases of pyocele underwent unilateral orchidectomy and 8 cases were treated by incision and drainage. 8 cases of hematoma were treated by exploration and evacuation and 2 cases were treated by orchidectomy. 6 cases of testicular torsion underwent unilateral orchidectomy and contralateral orchidopexy. 2 cases underwent bilateral orchidopexy. Scrotal wall abscess was treated by incision and drainage. CONCLUSIONS The most common cause of acute scrotum was epididymo-orchitis. Early exploration is the gold standard treatment for torsion.