Scrotal Disorders

Sexually transmitted Infections

The scrotum is the part male reproductive system hanging outside the body. It is made of skin and muscle and contains the testicles and its surrounding structures. It is outside the body as the lower temperature would help in sperm production.

  1. Hydrocele

A hydrocele forms when they is a collection of fluid around the testes. This can happen because of inflammation, infection or trauma. Most men would notice a swelling in the scrotum that is often painless with a mild dull ache. A physical examination by a doctor alone would usually be sufficient to diagnose a hydrocele.

Fortunately, hydroceles can resolve on its own and sometimes do not need treatment. Occasionally if a hydrocele is too big and causes inconvenience and discomfort, surgery might need to be performed.

  1. Varicocele

A varicocele is a condition where the veins around the testes become swollen. It usually does not cause any symptoms and only sometimes cause a dull ache in the scrotum. However, it is essential to treat this condition as it can lead to reduced sperm production and infertility as it affects the temperature of the testes.

To diagnose a varicocele, the doctor would perform a physical examination, often discovering a “bag of worms” on checking the testes. An ultrasound of the scrotum would also be ordered. Classically, surgery is done to remove the excess swollen veins but with recent advancement in treatment techniques, now minimally invasive vascular embolisation can be done as well by a vascular surgeon and interventional radiologist.

  1. Inguinal Hernia

An inguinal hernia is a condition where a portion of the small intestine goes through a weakness in the abdominal wall and enters the scrotum. Most men with this condition will notice a sudden swelling around the scrotum associated with some discomfort. This discomfort is usually made worse on straining and coughing. Men at risk of inguinal hernias are those who have chronic cough like smokers, those who are obese and those who strain often either during exercise or straining during urine or bowel movements.

Certain hernias if left untreated can lead to obstruction of the small intestines and cause the individual to become very ill. A hernia is diagnosed through a thorough history taking and physical examination and occasionally through scans. Surgery is often needed to push the intestines back into the abdomen and repair the defect in the abdominal wall.

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