Scrotum pain

Introduction Orchitis and epididymitis are one of the common causes of scrotal swelling. More than fever, epididymis, acute swelling of the testicles and acute exacerbation of pain, later turned into chronic, the pain will follow, and when it is light and heavy. Sometimes the patient can feel a painful little hard knot in the scrotum. Acute hyperthermia, chills, testicular pain to the groin, with nausea and vomiting; acute mumps orchitis, more than 3-4 days after the occurrence of mumps, high fever up to 40 °C often accompanied by collapse, scrotum redness, testicular swelling , hydrocele, obvious tenderness, such as mumps can also be found in parotid swelling.

Cause

The cause of scrotal fall pain:

Orchitis is a testicular inflammatory disease caused by various pathogenic factors and can be classified into non-specific, viral, fungal, spirochetic, parasitic, damaging, chemical, and the like. Specific orchitis is mostly caused by epididymal tuberculosis invading the testicles, which is very rare. Common in clinical practice are non-specific orchitis and mumps-induced orchitis, which is one of the common causes of male infertility.

(A) acute non-specific orchitis: acute non-specific orchitis often occurs in patients with urethritis, cystitis, prostatitis, prostate hyperplasia and long-term indwelling catheter. Infections spread through the lymph or vas deferens to the epididymis causing epididymal orchitis. Common pathogens are Escherichia coli, Proteus, Staphylococcus and Pseudomonas aeruginosa. Bacteria can be spread to the testes via blood, causing simple orchitis. However, testicular blood supply is abundant and has strong resistance to infection, so this situation is rare. Pathologically, the gross observation is mainly testicular enlargement, congestion, and tension. A small abscess was seen when the testis was cut. Histology showed focal necrosis, connective tissue edema and granulocyte infiltration of lobular cells, inflammation, hemorrhage, necrosis of the seminiferous tubules, and severe testicular abscess and testicular infarction.

(B) chronic non-specific orchitis: chronic orchitis is mostly caused by the incomplete treatment of non-specific acute orchitis. Can also be caused by mold, spirochete, parasitic infections, such as testicular syphilis, previous testicular trauma, granulomatous orchitis can occur. Local or whole body radioisotope phosphorus exposure to testicular testicular inflammation can also occur, destroying testicular tissue. Pathologically, the testicular swelling or cirrhosis atrophy, the basement membrane of the seminiferous tubules was glassy and degenerative, and the spermatogenic epithelial cells disappeared. There may be hardening around the seminiferous tubules, and small foci can also be formed.

(C) acute mumps orchitis: mumps is the most common cause of orchitis, about 20% of mumps patients with orchitis. More common in late adolescence. The testicles are highly enlarged and purple-blue in the naked eye. When the testis was incised, the testicular tubules could not be squeezed out due to interstitial reaction and edema. Histology and vasodilation were observed by histological observation. A large number of inflammatory cells infiltrated, and the seminiferous tubules were denatured to varying degrees. When orchitis heals, the testicles become smaller and softer. The seminiferous tubules are severely atrophied, but the testicular interstitial cells are preserved, so the secretion of testosterone is not affected.

an examination

Related inspection

Scrotal examination scrotum imaging

Examination and diagnosis of scrotal fall and pain:

Acute hyperthermia, chills, testicular pain to the groin, with nausea and vomiting; acute mumps orchitis, more than 3-4 days after the occurrence of mumps, high fever up to 40 °C often accompanied by collapse, scrotum redness, testicular swelling , hydrocele, obvious tenderness, such as mumps can also be found in parotid swelling.

Differential diagnosis

Differential diagnosis of scrotal fall and pain:

1, spermatic cord thickening and swelling: spermatic cord thickening swelling is one of the symptoms of spermatic inflammation.

2, the scrotum falls: Some men often feel the scrotum sinking heavily, or full of discomfort, accompanied by hidden pain. Most people think that this sex life is not relevant. In fact, the causes of scrotal swelling are various, both disease-related and non-disease factors.

3, scrotal swelling: scrotal swelling refers to the scrotal skin and its contents (sheath testicular, epididymis and spermatic cord) lesions, or abdominal contents (ascites viscera) and other into the human scrotum, resulting in increased scrotum volume.

4, scrotal enlargement: scrotal enlargement refers to the scrotal skin and its contents (sheath, testis, epididymis and spermatic cord) have lesions, or abdominal contents (ascites, internal organs) and other drops into the human scrotum, resulting in scrotal volume Increase.

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