Clinical study on cystic swellings of the scrotum in adults in a tertiary care hospital

Authors

  • Thammegowda Kemparaj Department of General Surgery, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Joseph Mathew Department of General Surgery, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20171143

Keywords:

Epididymal cyst, Hydrocele, Jaboulay’s procedure, Lord's placation

Abstract

Background: Cystic swellings of the scrotum are common clinical entities that surgeons encounter in daily practice. Males of all ages are affected. Today, considerable heterogeneity exists in their treatment. This study sought to identify the prevalence and patterns of presentation of these swellings in adults and evaluate the different modalities of surgical management.

Methods: A cross-sectional study was undertaken from January 2013 to December 2016. A total of 186 patients fulfilling the inclusion criteria were included. Data was collected using a proforma. All patients were managed surgically.

Results: Majority of cases (28%) were observed between 41-50 years (mean age 43.9 years). In 71%, mode of presentation was a painless, gradually progressive swelling. Mean duration of symptoms was 17.3 months. Primary vaginal hydrocele was the commonest swelling encountered (in 73.1%). Jaboulay’s procedure was undertaken in 75.2% of patients. Lord’s plication was associated with a comparatively shorter operative time, lesser postoperative scrotal edema and a shorter hospital stay. Epididymal cysts accounted for 19.4% and were managed by excision. The most common complication observed irrespective of surgery performed was scrotal edema (in 36%). Hematoma and infection were less frequently observed. Patients were followed-up for a mean period of 1.8 months. No recurrences were detected during this period.

Conclusions: Cystic swellings of the scrotum are conditions predominantly affecting middle-aged males. Among these, primary hydrocele is the commonest. Although Lord's plication is simpler and gives good results with fewer complications, Jaboulay’s procedure remains the gold standard for surgical management of hydrocele.

Metrics

Metrics Loading ...

Author Biography

Thammegowda Kemparaj, Department of General Surgery, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India

Assistant Professor,

Department of General Surgery

References

Valentino M, Barozzi L, Pavlica P, Rossi C. Imaging scrotal lumps in adults 2: cysts and fluid collections. In: Bertolotto M, Trombetta C (eds.). Scrotal Pathology, Medical Radiology. Diagnostic Imaging. Berlin Heidelberg: Springer-Verlag. 2012:180-7.

Lasheen A. Hydrocelectomy through the inguinal approach versus scrotal approach for idiopathic hydrocele in adults. J Arab Society Medical Research. 2012;7(2):68-72.

Nesbit JA. Hydrocele and spermatocele. In: Graham SD Jr, Keane TE, Glenn JF (eds). Glenn's Urologic Surgery. 7th Edition. Philadelphia: Lippincott Williams and Wilkins. 2004;528-32.

Kavoussi PK, Costabile RA. Surgery of the scrotum and seminal vesicles. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. Campbell Walsh Urology. 10th Edition. Philadelphia: Saunders Elsevier. 2012;1008-11.

Rochelle JC, Levine LA. Complications of benign adult penile and scrotal surgery. In: Loughlin KR. Complications of urologic surgery and practice: diagnosis, prevention, and management. Boca Raton FL: CRC Press; 2007;229-30.

Ku JH, Kim ME, Lee NK, Park YH. The excisional, plication and internal drainage techniques: a comparison of the results for idiopathic hydrocele. BJU Int. 2001 Jan;87(1):82-4.

Kiddoo DA, Wollin TA, Mador DR. A population based assessment of complications following outpatient hydrocelectomy and spermatocelectomy. J Urol. 2004;171(2):746-8.

Woodward PJ, Schwab CM, Sesterhenn IA. From the archives of the AFIP: extratesticular scrotal masses: radiologic- pathologic correlation. Radiographics. 2003;23:215-40.

Rubenstein RA, Dogra VS, Seftel AD, Resnick MI. Benign intrascrotal lesions. J Urol. 2004;171:1765-72.

Kumar SK, Sasikumar J, Seetharamaiah T, Kumar AB, Venugopalacharyulu NCH. Cystic swellings of scrotum: management. IJMRHS. 2014;3(2):338-41.

Leung ML, Gooding GA, Williams RD. High-resolution sonography of scrotal contents in asymptomatic subjects. Am J Roentgenol. 1984;143:161-4.

Slavis SA, Kollin J, Miller JB. Pyocele of the scrotum: Consequence of spontaneous rupture of testicular abscess. Urology. 1989;33:313-6.

Bruner DI, Ventura EL, Devlin JJ. Scrotal pyocele: Uncommon urologic emergency. J Emergencies Trauma Shock. 2012;5(2):206.

Swartz MA, Morgan TM, Krieger JN. Complications of scrotal surgery for benign conditions. Urology. 2007;69(4):616-9.

Kim JK, Shin JH, Lim JS. A 10-year retrospective study of the operative treatment results of adult type hydrocele. Korean J Urol. 2008;49(1):82-7.

Rodríguez WC, Rodríguez DD, Fortuño RF. The operative treatment of hydrocele: a comparison of four basic techniques. J Urol. 1981;12(6):804-5.

Jahnson S, Johansson JE. Results of window operation for primary hydrocele. Urology. 1993;41:27-8.

Downloads

Published

2017-03-25

How to Cite

Kemparaj, T., & Mathew, J. (2017). Clinical study on cystic swellings of the scrotum in adults in a tertiary care hospital. International Surgery Journal, 4(4), 1364–1370. https://doi.org/10.18203/2349-2902.isj20171143

Issue

Section

Original Research Articles