Makindo Medical Notes.com

Introduction

• Definition: Scrotal or testicular pain refers to discomfort or pain in the scrotum, the pouch of skin containing the testicles, or in the testicles themselves. Lump or swelling in the scrotal area can range from benign to serious causes. Early evaluation and diagnosis are crucial to managing the underlying condition effectively.

Diagnostic Approach:

• History/Examination: Ask about pain onset, duration, characteristics, and associated symptoms. Examine for swelling, tenderness, or lumps.
• Ultrasound: Used to distinguish between fluid-filled, solid, or vascular structures and assess blood flow (e.g., in torsion).
• Urinalysis and STI Testing: Check for infection - epididymitis or orchitis.
• Tumour Markers: Alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (beta-hCG), and LDH to evaluate for testicular cancer.

Causes

Red Flags:

• Testicular Torsion: Acute, severe scrotal pain requires immediate evaluation.
• Testicular Cancer: Painless lumps or swelling should be evaluated promptly.
• Inguinal Hernia with Strangulation: Sudden severe pain and a tender bulge may indicate a trapped hernia.

Treatment:

• Surgical Intervention: Required for testicular torsion, hernia, varicocele, and testicular cancer.
• Antibiotics: For bacterial causes like epididymitis or orchitis.
• Supportive Care: Rest, scrotal elevation, and analgesics for non-emergent or viral causes of pain.