Scrotal abscess: Varied etiology, associations, and management

Abstract

Aim:To report a series of scrotal abscess, a rare problem, their etiology, and management.Materials and Methods:A retrospective study of children who presented with scrotal abscess between January 2010 and March 2015, analyzed with respect to clinical features, pathophysiology of spread and management.Results:Eight infants and a 3-year-old phenotypically male child presented with scrotal abscess as a result of abdominal pathologies which included mixed gonadal dysgenesis (MGD) [1]; three anorectal malformations with ectopic ureter [1], urethral stricture [1], and neurogenic bladder [1]; meconium peritonitis with meconium periorchitis [2], ileal atresia [1], and intra-abdominal abscess [1]; posturethroplasty for Y urethral duplication with metal stenosis [1] and idiopathic pyocele [1]. Transmission of the organism had varied routes include fallopian tube [1], urethra ejaculatory reflux [4], hematogenous [2], and the patent process of vaginalis [2]. Two of the nine required extensive evaluation for further management. Treating the predisposing pathology resolved scrotal abscesses in eight of nine patients, one of whom, required vasectomy additionally. Idiopathic pyocele responded to needle aspiration and antibiotics.Conclusion:Scrotal abscess needs a high index of suspicion for predisposing pathology, especially in infants. Laparoscopy is safe and effective in the management of the MGD and ectopic ureter.

Scrotal abscess due to urethral fistula in spinal cord injured patient with prolonged indwelling urinary catheter

“…The etiology of scrotal abscesses varies greatly, some of which have been reported including epididymo-orchitis, neglected testicular torsion, spread from intra-abdominal abscess and hematogenous route of systemic infection. [ 4 ] In differential diagnosis of a scrotal mass in patient with paraplegia, especially when a urinary tract infection observed, epididymo-orchitis and urethro-scrotal abscess should be suspected. [ 5 ] Retrograde urethrography is considered a standard diagnostic technique for the morphology of the urethra and to confirm and characterize the fistula.…”

Pitfalls and Practical Challenges in Imaging of the Pediatric Scrotum

“…An abscess within the scrotum is rare in the pediatric age group. Most abscesses are due to extension of epididymo-orchitis or missed torsion 68–70 . On US, an abscess appears as a hypoechoeic mass that may be anechoic but more commonly contain low-level echoes (Fig.…”