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Leiomyomas are benign mesenchymal tumors which arise from smooth muscle cells. They are most commonly encountered in the uterus but leiomyomas originating from the scrotum is a rare entity and very few cases are reported in literature so far. There are three types of superficial leiomyoma based on their site of origin: piloleiomyoma arising from arrector pili, scrotal leiomyoma arising from dartos muscle, and angioleiomyoma arising from smooth muscles of blood vessels. Herein, we report a case of scrotal leiomyoma in a 60 years old male which was clinically diagnosed as sebaceous adenoma and was excised. Histopathological and Immunohistochemical features were consistent with leiomyoma and final diagnosis of scrotal leiomyoma was given. [ABSTRACT FROM AUTHOR]

We have reported the case of a 36-year-old man with severe scrotal swelling that had remained undiagnosed after multiple diagnostic tests. The patient had presented with scrotal swelling, multiple weeping ulcers on the dorsal aspect of the scrotum, and worsening pain affecting his day-to-day functioning. Duplex ultrasound showed low- to no-flow hypervascularity and dependent edema suspicious for a vascular malformation. Treatment included sequential Gelfoam (Pfizer, New York, NY) embolization using ultrasound-guided direct cannulation and traditional angiography. The scrotal circumference decreased by 65%, with moderate relief of his pain. The details from the present case have highlighted the significance of vascular malformations, various diagnostic and therapeutic techniques used, and value of endovascular embolization.

The condition known as scrotal elephantiasis is a debilitating rarity where the scrotum undergoes significant swelling, typically arising from chronic obstructive lymphedema. A case is presented of a 60-year-old man who had suffered severe and persistent enlargement of his scrotum for multiple years. This affliction greatly affected both his ability to function effectively and caused detrimental psychosocial consequences.After a clinical evaluation, the patient was diagnosed with scrotal elephantiasis.A comprehensive strategy was adopted, utilizing scrotal volume reduction surgery to yield a significant enhancement in the quality of life following the operation.

Leiomyomas are benign mesenchymal tumors which arise from smooth muscle cells. They are most commonly encountered in the uterus but leiomyomas originating from the scrotum is a rare entity and very few cases are reported in literature so far. There are three types of superficial leiomyoma based on their site of origin: piloleiomyoma arising from arrector pili, scrotal leiomyoma arising from dartos muscle, and angioleiomyoma arising from smooth muscles of blood vessels. Herein, we report a case of scrotal leiomyoma in a 60 years old male which was clinically diagnosed as sebaceous adenoma and was excised. Histopathological and Immunohistochemical features were consistent with leiomyoma and final diagnosis of scrotal leiomyoma was given.

This article summarizes and updates a number of issues related to hydrocele including anatomy, embryology, classification, etiology, clinical manifestations, imaging findings, and management. Hydrocele is an abnormal collection of serous fluid between the parietal and visceral layers arising from the mesothelial lining of the tunica vaginalis that surrounds the testis and spermatic cord directly. Hydroceles result from an imbalance of secretion and reabsorption of fluid from the tunica vaginalis. Hydroceles can be divided into two types as primary and secondary. The diagnosis should be based on medical history, clinical manifestations, and imaging studies. Understanding the causes and types of hydroceles is useful for accurately diagnosing and treatment strategy. Hydroceles can be managed by conservative treatment, fluid aspiration, or hydrocelectomy. [ABSTRACT FROM AUTHOR]

Abstract Background Scrotal swelling is a clinical situation which can be caused by different aetiologies. In this case report, we describe a multi-week episode of unilateral and bilateral scrotal swelling in boars at an Austrian boar stud and its diagnostic work-up. Case presentation In the summer of 2020, the herd veterinarian of an Austrian boar stud reported that over a period of six weeks, five out of 70 boars presented with unilateral severe swelling of the left scrotum and three out of 70 boars with bilateral severe swelling of the left and moderate swelling of the right scrotum, respectively. A complete history was obtained and an on-site evaluation of the facility was done. Five boars were necropsied, and a variety of samples harvested for further diagnostic investigations. Infectious differential diagnoses associated with unilateral swelling of the scrotum or the testis were excluded through serological and tissue testing. In three of the five boars, histopathology revealed complete acute haemorrhagic necrosis of the left testis concurrent with strongly congested blood vessels. Review of the collected information with a group of experts in the field of boar stud management resulted with consensus that, most likely, trauma was the etiologic event causing the clinical signs and pathology. Coincident with discussion of implementing video recording cameras in the boar housing area, no further clinical cases followed. As this case occurred during the first lockdown of the COVID-19 pandemic, we propose that the distress and travelling restrictions may have contributed to frustration among boar stud workers, which was consequently expressed as misbehaviour against boars. Conclusions Once all known infectious causes of unilateral swelling of the scrotum were excluded, a critical diagnostic work-up focused on non-infectious causes. Non-infectious causes, such as trauma, need to be carefully evaluated, as it may also include human misbehaviour against boars. Summarizing all findings of this case report, the authors hypothesize that a blunt trauma was the reason for the series of mainly unilateral swelling of the scrota of boars.

PurposeThis case report aims to enhance the understanding of clinical physicians regarding splenogonadal fusion (SGF) and to help them consider SGF as a differential diagnosis when testicular tumors are suspected, thus avoiding unnecessary orchiectomies.MethodsWe report three cases of SGF admitted to our hospital, one of which presented as a suspected testicular tumor. We also searched the literature on scrotal masses from the last 25 years and summarize the characteristics of cases of SGF manifesting as scrotal swelling combined with our cases.ResultsAfter conducting a thorough search, we found a total of 24 publications relevant to this case study, which included 25 testes. All lesions were located on the left side, and the average age of those affected was 20.22 years. Seven cases were of the continuous type. Three cases presented with pain, all of which were intratesticular masses. Thirty cases had a definite onset duration, ranging from 3 weeks to 10 years. Nine patients (36%) underwent orchiectomy, and one underwent partial orchiectomy.ConclusionIt is crucial to identify SGF in the clinic. When a patient presents with scrotal swelling, diagnosing SGF preoperatively is challenging, and it should be considered when there is a long history of a stable testicular mass. An intraoperative frozen section should be performed if a testicular tumor is suspected to avoid unnecessary orchiectomy.

We aim to provide our surgical techniques, and outcomes of functional scrotal reduction procedures with complete preservation of the genitourinary original anatomy in a simple way without using complicated skin grafting or skin advancement flaps in Patients with huge and long-standing scrotal lymphedema 18 patients ages ranged from 14-65 with a median of 30 years. Functional scrotal and penoscrotal reduction was attained in all cases, without distortion of the genitourinary anatomy and without the need for advancement, rotational or free flaps, maximal scrotal diameter was reduced from median of 61[48-92] cms to a median of 25[21–29] cms (P

Background: Testicular masses can be a sign of various medical problems, ranging from acute emergencies such as testicular torsion to chronic illnesses such as cancer. Therefore, examinations, including self-examinations, are an important procedure for diagnosis and treatment, which can help prevent complications such as loss of fertility. Aims: The aim of this study was to evaluate the level of awareness about scrotal swelling among adult men in Saudi Arabia. Materials and Methods: A cross-sectional survey was administered to 3502 males, aged 18–50 years, from August 2021 to March 2022. Results: A total of 3502 participants from different regions of Saudi Arabia responded to our survey over 43 days, from August 21, 2021 to October 3, 2021. Unmarried, Master's/PhD graduated male, showed a high level of knowledge and attitude toward testicular swelling. Conclusion: The prevalence of cases of scrotal swelling, coupled with the lack of reporting or immediate intervention, was one of the reasons for the lack of research about this subject. The study notices several factors which impacted on participants' awareness of scrotal swelling and the risks it poses. The results also emphasized the importance of self-examination in respect to the avoidance of complications such as testicular cancer.

Background: Scrotal swelling is a clinical situation which can be caused by different aetiologies. In this case report, we describe a multi-week episode of unilateral and bilateral scrotal swelling in boars at an Austrian boar stud and its diagnostic work-up. Case presentation: In the summer of 2020, the herd veterinarian of an Austrian boar stud reported that over a period of six weeks, five out of 70 boars presented with unilateral severe swelling of the left scrotum and three out of 70 boars with bilateral severe swelling of the left and moderate swelling of the right scrotum, respectively. A complete history was obtained and an on-site evaluation of the facility was done. Five boars were necropsied, and a variety of samples harvested for further diagnostic investigations. Infectious differential diagnoses associated with unilateral swelling of the scrotum or the testis were excluded through serological and tissue testing. In three of the five boars, histopathology revealed complete acute haemorrhagic necrosis of the left testis concurrent with strongly congested blood vessels. Review of the collected information with a group of experts in the field of boar stud management resulted with consensus that, most likely, trauma was the etiologic event causing the clinical signs and pathology. Coincident with discussion of implementing video recording cameras in the boar housing area, no further clinical cases followed. As this case occurred during the first lockdown of the COVID-19 pandemic, we propose that the distress and travelling restrictions may have contributed to frustration among boar stud workers, which was consequently expressed as misbehaviour against boars. Conclusions: Once all known infectious causes of unilateral swelling of the scrotum were excluded, a critical diagnostic work-up focused on non-infectious causes. Non-infectious causes, such as trauma, need to be carefully evaluated, as it may also include human misbehaviour against boars. Summarizing all findings of this case report, the authors hypothesize that a blunt trauma was the reason for the series of mainly unilateral swelling of the scrota of boars. [ABSTRACT FROM AUTHOR]

Scrotal swellings in neonates are very common. A 25-day-old male child had right-sided firm, nontender scrotal swelling. Ultrasound scan (USS) diagnosed as meconium periorchitis (MPO). At 70 days of age, repeat USS and plain abdominoscrotal radiograph confirmed MPO, and surgery was avoided. Radiological diagnosis and management of MPO are discussed.

Background: Testicular masses can be a sign of various medical problems, ranging from acute emergencies such as testicular torsion to chronic illnesses such as cancer. Therefore, examinations, including self-examinations, are an important procedure for diagnosis and treatment, which can help prevent complications such as loss of fertility. Aims: The aim of this study was to evaluate the level of awareness about scrotal swelling among adult men in Saudi Arabia. Materials and Methods: A cross-sectional survey was administered to 3502 males, aged 18-50 years, from August 2021 to March 2022. Results: A total of 3502 participants from different regions of Saudi Arabia responded to our survey over 43 days, from August 21, 2021 to October 3, 2021. Unmarried, Master's/PhD graduated male, showed a high level of knowledge and attitude toward testicular swelling. Conclusion: The prevalence of cases of scrotal swelling, coupled with the lack of reporting or immediate intervention, was one of the reasons for the lack of research about this subject. The study notices several factors which impacted on participants' awareness of scrotal swelling and the risks it poses. The results also emphasized the importance of self-examination in respect to the avoidance of complications such as testicular cancer. [ABSTRACT FROM AUTHOR]

Scrotal swellings in neonates are very common. A 25-day-old male child had right-sided firm, nontender scrotal swelling. Ultrasound scan (USS) diagnosed as meconium periorchitis (MPO). At 70 days of age, repeat USS and plain abdominoscrotal radiograph confirmed MPO, and surgery was avoided. Radiological diagnosis and management of MPO are discussed. [ABSTRACT FROM AUTHOR]

We aim to provide our surgical techniques, and outcomes of functional scrotal reduction procedures with complete preservation of the genitourinary original anatomy in a simple way without using complicated skin grafting or skin advancement flaps in Patients with huge and long-standing scrotal lymphedema 18 patients ages ranged from 14-65 with a median of 30 years. Functional scrotal and penoscrotal reduction was attained in all cases, without distortion of the genitourinary anatomy and without the need for advancement, rotational or free flaps, maximal scrotal diameter was reduced from median of 61[48-92] cms to a median of 25[21–29] cms (P <0.0001) and remained almost unchanged at the end of the follow up period 26[22-34] cms (P <0.0001). Sexual performance and voiding capacity were improved in all patients, testicular vascularity was unaffected and the Glasgow Benefit Inventory (GBI) for the quality of life showed marked enhancement in the total 55.5[50–72], general 55.5[50–72], social 100[50–100] and physical 16.6[16–33] points subscales. According to our experience, surgery remains the gold standard treatment for management of huge scrotal lymphedema, successful preservation of the genitourinary functions can be attained despite the size in most cases with excellent cosmoses. [ABSTRACT FROM AUTHOR]

Leiomyoma is a benign tumor that arises from smooth muscle. It may be encountered at any part of the body especially the uterus. However, scrotal localization is very uncommon, hence it often requires radiologic and pathology correlation to establish an accurate diagnosis and make optimal decisions for subsequent treatment. We present a case of an 82-years-old male, presenting with a left scrotal mass. Ultrasound and MRI demonstrated a left paratesticular mass. Surgery was then indicated and pathology results were consistent with a scrotal leiomyoma.

Ventriculo-peritoneal (VP) shunt is the typical and most common procedure for the treatment of hydrocephalus. Many complications have been associated with VP shunts, migration of the distal end of the VP tube into the scrotum is a rare one. We report the presentation and management of a case of 3 month age infant who had scrotal swelling primarily diagnosed as hydrocele. Investigations proved the presence of shunt migration. The possibility of shunt migration should be considered. Early diagnosis and management of such complications is easy and can prevent subsequent serious sequelae.

None.

Hydrocele can be defined as an abnormal collection of fluid within the tunica vaginalis of the scrotum or along the spermatic cord. Giant hydroceles contain over 1 L of fluid and are rare. Communicating hydrocele, which occurs due to abnormal persistence of patency of the processus vaginalis (PV), is usually found in infants. This patency has been known to persist in some adults usually giving rise to an indirect inguinal hernia if symptomatic. Very rarely may also be a cause of hydrocele in adults. We managed a 36-year-old man who had a recurrent left scrotal swelling. High ligation of the left patent PV was done and 1.1 L of scrotal fluid collection drained. Giant hydrocele from communicating hydrocele is very rare. A communicating hydrocele should be considered as a differential diagnosis in an adult who develops a recurrence following open drainage of a hydrocele. Health education and improvements in standards of living will prevent communicating hydrocele from developing into giant hydrocele.

Discovery of scrotal swelling in a neonate can be a source of anxiety for parents, clinicians, and sonologists alike. This pictorial essay provides a focused review of commonly encountered scrotal masses and mimics specific to the neonatal setting. Although malignancy is a concern, it is very uncommon, as most neonatal scrotal masses are benign. Key discriminating features and management options are highlighted to improve the radiologist's ability to diagnose neonatal scrotal conditions and guide treatment decisions. Neonatal scrotal processes ranging from common to uncommon will be discussed.

Abstract Bilateral epididymal cysts are infrequent particularly in children. They commonly arise from the epididymal head. Cysts arising from the epididymal tails are very rare. Spontaneous resolution may occur with no need for surgical excision of cysts and can take up to 50 months.

Myxoma is a rare benign mesenchymal neoplasm. Scrotal myxomas can be either cutaneous or intramuscular. Muscular myxomas are usually found in cardiac muscles and skeletal muscles of the extremities. The most common locations of cutaneous myxomas are the trunk, lower extremities, and the head and neck. However, these lesions can rarely arise in the genital area (vulva, mons pubis, and scrotum). The clinical presentation of this lesion is nonspecific, and it is difficult to make a diagnosis before a biopsy and microscopic examination. Scrotal myxomas are infrequent and can cause definite diagnostic problems.  We report a case of a 64-year-old male who presented to the surgery outpatient department with a history of scrotal swelling for 20 years. The swelling was excised and sent for histopathological examination. Histopathological examination revealed features of scrotal cutaneous myxoma., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Devi D et al.)

Acquired urethral diverticula in male patients are a rare finding. We report a case of a 70-year male with a past medical history of type 2 diabetes who presented with post micturition dribbling and a scrotal mass which was identified as a urethral diverticulum. We also outline the surgical management in this patient and review similar cases reported in the literature.

Introduction: Most of the painful extratesticular scrotal lesions are erroneously diagnosed and treated in our clinical practice. Therefore, this study was undertaken to analyze the usefulness of a combination of clinical, radiological, cytological, and microbiological assessment in establishing the accurate diagnosis of this lesion. Aim: To study the Clinical, Radiological, Cytological and Microbiological assessment of painful extra-testicular lesions and their correlation with each other in establishing the accurate diagnosis of these lesions. Objectives: The objectives of the study were to assess the diagnostic significance of clinical, radiological, cytological, and microbiological methods and their correlation in establishing the accurate diagnosis of painful extratesticular lesions. Materials and Methods: This cross-sectional study was carried out in Departments of Surgery, Radiology, Pathology, and Microbiology, University College of Medical Sciences and GTB Hospital over the period of 2 years. During this period, we were able to accommodate 75 patients in the study, who presented with pain and swelling in the scrotum and clinically found to have extratesticular swellings. Radiological assessment was done on the 1st day of visit, using Grayscale ultrasonography along with Color Doppler of these lesions. For cytological assessment, ultrasound-guided fine-needle aspiration cytology and microbiological assessment were done from the aspirate remaining after making cytology slide. Statistical Analysis: Data analysis was done using SPSS statistical software. Kappa statistics were used to find the degree of agreement or concordance between clinical, radiological, cytological, and microbiological findings. Results: Clinically 71 patients were found to have tender extratesticular swellings, whereas in four patients, these swellings were nontender on clinical examination. Radiologically, epididymitis was found in 32 patients. Only in 37 patients out of 75, a definite diagnosis could be made on cytology. The microbiological examination did not give any positive results. Conclusion: Painful extratesticular scrotal lesion often poses a diagnostic dilemma in the mind of treating physician. Clinical findings of these lesions may be corroborated through radiological, cytological, and microbiological assessment in an endeavor to arrive at a definitive diagnosis with a defined etiology.

Xanthogranulomatous orchitis (XGO) is a benign non-inflammatory condition predominantly affecting the testicular tissue and characterized by the infiltration of lipid-laden macrophages leading to substantial tissue damage. We present the case of an 80-year-old gentleman with chronic pyocele and concurrent testicular atrophy secondary to XGO, a seldom-reported manifestation in the testicular milieu. The patient presented with a protracted history of left-sided scrotal swelling and underwent left orchidectomy subsequent to preoperative diagnosis via ultrasonography. Intraoperative exploration revealed the presence of purulent fluid, and histopathological analysis confirmed characteristic features of XGO, including seminiferous tubule destruction and infiltration of fibroconnective tissue by histiocytes and dilated blood vessels. Differential diagnosis with testicular neoplasms posed a challenge, accentuating the pivotal role of histopathological scrutiny in achieving precise diagnosis. Orchidectomy remains the cornerstone of treatment for XGO. This case underscores the imperative of considering XGO in the diagnostic spectrum of testicular masses and the indispensable role of histopathology in confirming the diagnosis and guiding optimal therapeutic interventions., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Bhole et al.)

Paratesticular tumors are rare and account for 7% of intrascrotal neoplasms which generally present as painless inguinal or scrotal swelling. Around 200 cases of paratesticular liposarcoma cases have been reported worldwide. They are usually misdiagnosed before surgery. Incomplete treatment may lead to local recurrence. We report a rare case of paratesticular liposarcoma. A 65-year-old man presented with right scrotal painless swelling for 2 years and gradually increasing in size. On examination, swelling in the right inguinal scrotal region was cystic in consistency. Testicular tumor markers were normal. The patient underwent right high orchidectomy with tumor excision. Sample sent for biopsy. Histopathological study reveals paratesticular liposarcoma. The long-term survival is approximately 50% with a favorable prognosis. [ABSTRACT FROM AUTHOR]

Complete removal of all the contents of a hernial sac is crucial in laparoscopic inguinal hernia repair. We report a case who underwent transabdominal preperitoneal repair for a complete, irreducible inguinal hernia. He had persistent scrotal swelling and new onset scrotal pain post‐surgery. Ultrasonography of the scrotum revealed a well‐defined hypoechoic scrotal lesion. A magnetic resonance imaging revealed a fat‐containing mass lesion, hypointense on T2 fat‐saturated image. He underwent exploration of the scrotum and a well‐encapsulated mass was excised. The histopathological evaluation revealed a well‐encapsulated structure comprising of lobules of fibroadipose tissue with foci of chronic inflammation and foamy histiocytes likely retained omentum from previous surgery. His scrotal pain disappeared post‐excision. A missed retained omentum in the hernial sac causes considerable anxiety to patients and diagnostic and therapeutic dilemmas for the treating surgeon. We coined the term "omentaloma of the scrotum" for such a lesion. [ABSTRACT FROM AUTHOR]

Paratesticular myxoid liposarcoma is an exceedingly rare malignancy originating from the spermatic cord or paratesticular tissues. We report a unique case of a 75-year-old male patient who presented with a painless scrotal swelling that had been growing for four years. Imaging investigations, including ultrasonography (USG) and contrast-enhanced computerized tomography (CECT), revealed characteristics consistent with paratesticular myxoid liposarcoma. The orchidectomy specimen confirmed a grade 2 right paratesticular myxoid liposarcoma. Despite its rarity, clinicians must consider this tumor in the differential diagnosis of painless scrotal swellings. Accurate diagnosis and comprehensive management, encompassing surgical resection with wide margins and potential adjuvant therapies, are pivotal. This case underlines the importance of collaborative research and long-term follow-up in understanding and managing paratesticular myxoid liposarcomas., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Arutperumselvi et al.)

A scrotal abscess following perforated appendicitis is a rare complication. This is mostly seen in children and usually occurs due to the presence of the patent processus vaginalis, which permits the passage of pus from the intra-abdominal cavity down to the scrotum, resulting in a scrotal pyocele. There are few reported cases of such complications in young adult patients. We report a case of a 50-year-old male with a scrotal pyocele following exploratory laparotomy for perforated appendicitis. Scrotal ultrasound (US) findings were suggestive of a right-sided scrotal abscess, and the CT scan showed prominent fat in the proximal part of the right inguinal canal, which suggested the presence of a partially patent processus vaginalis. Our case is the first reported in the middle-aged group, and our review of the literature is the first directed to the adult age group. This review emphasizes the importance of considering scrotal pyocele in any patient with acute scrotum post-appendectomy, regardless of the patient's age, the affected side, and the presence or absence of identifiable patent processus vaginalis, as it may be microscopically permeable. Treatment will entail urgent drainage of the abscess, together with a course of antibiotics., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Al Bazroon et al.)

Bilateral epididymal cysts are infrequent particularly in children. They commonly arise from the epididymal head. Cysts arising from the epididymal tails are very rare. Spontaneous resolution may occur with no need for surgical excision of cysts and can take up to 50 months. [ABSTRACT FROM AUTHOR]

Objective: Acute scrotum is an emergency condition needs early intervention. The aim of our study has been to evaluate the findings in boys operated on acute scrotum. Method and material: Descriptive study was conducted on 100 patients less than 14 years with acute scrotum admitted to MTI/LRH Peshawar from June 2016 to May 2018 data included history, age, primary symptoms/sign definite diagnosis, side involvement, clinical tests, imaging modalities, medical/surgical management and type of surgery. Results: Diagnosis was made mainly by clinical signs and symptoms and surgical exploration. spermatic cord torsion (n=40) was the most common cause of acute scrotum, followed by incarcerated inguinal torsion (n=25) of testicular appendage (n=20) epididymo orchitis (n=10), idiopathic scrotal oedema (n=2), hematocoele (n=3). Most 35% of patients were in the first year of life and the mean age was 5.5 years. the commonest signs were pain and swelling (70%) followed by pain, swelling and redness 20% and pain alone (15%). 60 patients consisting torsion of spermatic and torsion of testicular appendage, 25 patients with incarcerated inguinal hernia and 10 patients with epididymo orchitis underwent surgical exploration after care full physical examination. 10 out of 40 patients with torsion of testis had orchidectomy and orchidopexy of contralateral testis and the rest had detorsion and bilateral orchidopexy. 80% of the patients were referred to the hospital offer 12 hours of clinical onset of symptoms. Conclusion: Early exploration of acute scrotum based on care full physical examination is a relatively safe and simple procedure with good cosmetic results. It also allows an accurate diagnosis to be made. [ABSTRACT FROM AUTHOR]

Introduction: Most of the painful extratesticular scrotal lesions are erroneously diagnosed and treated in our clinical practice. Therefore, this study was undertaken to analyze the usefulness of a combination of clinical, radiological, cytological, and microbiological assessment in establishing the accurate diagnosis of this lesion. Aim: To study the Clinical, Radiological, Cytological and Microbiological assessment of painful extra-testicular lesions and their correlation with each other in establishing the accurate diagnosis of these lesions. Objectives: The objectives of the study were to assess the diagnostic significance of clinical, radiological, cytological, and microbiological methods and their correlation in establishing the accurate diagnosis of painful extratesticular lesions. Materials and Methods: This cross-sectional study was carried out in Departments of Surgery, Radiology, Pathology, and Microbiology, University College of Medical Sciences and GTB Hospital over the period of 2 years. During this period, we were able to accommodate 75 patients in the study, who presented with pain and swelling in the scrotum and clinically found to have extratesticular swellings. Radiological assessment was done on the 1st day of visit, using Grayscale ultrasonography along with Color Doppler of these lesions. For cytological assessment, ultrasound-guided fine-needle aspiration cytology and microbiological assessment were done from the aspirate remaining after making cytology slide. Statistical Analysis: Data analysis was done using SPSS statistical software. Kappa statistics were used to find the degree of agreement or concordance between clinical, radiological, cytological, and microbiological findings. Results: Clinically 71 patients were found to have tender extratesticular swellings, whereas in four patients, these swellings were nontender on clinical examination. Radiologically, epididymitis was found in 32 patients. Only in 37 patients out of 75, a definite diagnosis could be made on cytology. The microbiological examination did not give any positive results. Conclusion: Painful extratesticular scrotal lesion often poses a diagnostic dilemma in the mind of treating physician. Clinical findings of these lesions may be corroborated through radiological, cytological, and microbiological assessment in an endeavor to arrive at a definitive diagnosis with a defined etiology. [ABSTRACT FROM AUTHOR]

A gross hydrocele is caused by fluid accumulation within a layer wrapped around the testicle, called the tunica vaginalis, derived from the peritoneum. A 65-year-old male complained of a non-tender, fluctuant bulge in his right scrotum despite having a fully buried penis, a large hydrocele, and urinary retention. After ultrasonography, the diagnosis was confirmed, and the patient underwent a successful surgical procedure that included a hydrocelectomy and tunica vaginalis excision. The patient reported few postoperative complications and a notable improvement in his quality of life. Surgery is a successful approach for treating gross hydrocele, with minimal morbidity and excellent cosmetic outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Pathrikar et al.)

Hydrocele represents a commonly encountered pathological condition characterized by the development of scrotal swelling. In contrast, spermatic cord hydrocele is a relatively rare condition that arises from the abnormal closure of the processus vaginalis. This condition entails the accumulation of fluid within the spermatic cord, and although hydrocele itself is a frequently observed ailment affecting roughly 100 out of 100,000 men, encysted hydrocele of the spermatic cord is a seldom-seen variant. Furthermore, it is noteworthy that spermatic cord hydrocele tends to be more prevalent in the pediatric population compared to adults. In our clinical practice, a patient presented with swelling localized to the right hemi-scrotum and was initially diagnosed as suffering from a chronic right-sided hydrocele of the tunica vaginalis. However, during the surgical intervention, the true nature of the condition became evident, as it was determined to be an encysted hydrocele of the cord. This case report chronicles the diagnostic journey surrounding hydrocele, highlighting the distinction in surgical management between encysted hydrocele and vaginal hydrocele of the testis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Jain et al.)

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Urethroscrotal fistula is a very rare pathology and is divided into congenital and acquired types. Herein we report a 4.5-year-old child with recurrent scrotal swelling and final diagnosis of urethroscrotal fistula. Clinicians should be aware and consider this disease in the differential diagnosis of any scrotal swelling, especially recurrent type. As far as we are aware, this is the first report of urethroscrotal fistula in patients under 5 years of age. [ABSTRACT FROM AUTHOR]

The intrascrotal calculus was first described during surgery by Kickham in 1935 as a “fibrinoid loose body” or “scrotal pearl.” The etiology of scrotal calculi is unclear. They may develop as a sequela to hematomas or inflammatory changes within the scrotum or loose bodies from torsion and infarction of the appendix testis or epididymis. Hardly few cases were reported in the literature. We present a case of painless right scrotal swelling since 6 years’ duration which gradually increased in size after following trauma. Finally, it is diagnosed as calcified hematoma and excision of the scrotal swelling was carried out after the exclusion of other causes (testicular malignancy) of scrotal swelling.

Background: Retroperitoneal haematoma could be caused by different factors. It is increasing due to an increase in the use of antithrombotic and anticoagulant therapy. Diagnosis of retroperitoneal haematoma forms a big challenge in daily clinical practice. Patients with retroperitoneal haematoma could present with leg paresis, abdominal pain, shock or abdominal compartment syndrome. Retroperitoneal haematoma could be treated conservatively but surgical interference or embolization of the bleeding vessels is always an option. Objectives: To present a case with spontaneous retroperitoneal haematoma presenting with scrotal haematoma together with a mini- review of retroperitoneal haematoma. Conclusions: Retroperitoneal haematoma may present with a scrotal swelling and could be treated conservatively depending on the presentation and severity of the bleeding.