SCROTAL SWELLING ETIOLOGY, CLINICAL MANIFESTATIONS AND MANAGEMENT

Abstract

Aims and Objective: To study etiology, clinical manifestations, Imaging and management of scrotal swellings.

Observations and Results: The numbers of patients enrolled in this study were 343. The mean age of the patients was 48.39 11.371 years with a range more than 18 years. Primary vaginal hydrocele was most commonly observed in more than 40 to 50 years of age group accounting for 44.5% of the total patients. Swelling was the most common complaint amongst the subjects i.e. 100% Associated pain was observed in 135 (39.3%) subjects and fever was there in 35 patients. All 343(100%) subjects had getting above the swelling positive fluctuation was present in 321(93.6%) patients; Transillumination was present in 270 (78.7%) subjects. Ultrasonography was done in all subjects among which 307 (89.50%) were hydrocele, Epididymoorchitis were 18(5.2%), pyocele was 12 (3.5%), testicular malignancy were 6 (1.8%). Ultrasonography was a fairly sensitive imaging study for diagnosis of patients. Serological marker was done in all testicular malignancy and suggested significant elevation i.e. serum Alpha Feto protient was more than 10 ng/ml , serum beta HCG was more than 5IU/ml Serum LDH more than normal limit of 120 to 280 u/L in all cases 6.

Conclusion: Patients were operated with eversion of sac 296 (86.3 %), Lord’s plication was done in 3(0.9%) for Hydrocele, Orchidectomy was done in 16 (4.7%), incision and drainage was done in cases of Pyocele 12 (3.5%) and patients of epididymoorchitis 16 (4.66%) patients were managed conservatively. In this study only 4 (1.1%) patients developed post operative haematoma and 5 (1.45%) patients had post operative surgical site infection. Thus, this study states that surgical management is gold standard for scrotal swelling and remains mainstay treatment.