Scrotum Abscess

Abscess or collection of pus inside the scrotal sac is termed as scrotal abscess.

There can be many causes of getting a scrotal abscess. They include various kinds of infections in and around the scrotum.

Common Causes

  • Folliculitis on the scrotal surface
  • Testicular infection
  • Epididymitis
  • Drainage from ruptured appendix into the scrotal sac

Folliculitis

Pulled hair over the scrotal skin may infect the hair follicle. Such infections may spread to surrounding area, if left untreated. Small abscess may also be formed.

Epididymitis

The coiled tube-like canal behind the testes, that carry and store the sperms is called epididymis.

Symptoms

  • Pain in the area. This is only on the affected side. It is aggravated while you pass stool.
  • Urgency and increased frequency of urination. Act of urinating is also painful.
  • Swelling and redness over the affected scrotum
  • Enlarged lymph nodes in the inguinal area
  • Fever, mild to moderate
  • Discharge from the penis, may be with urine. Sometimes, blood may be seen in semen.

Causes

Epididymitis is most commonly cause due to some bacterial infection or STDs, like chlamydia or gonorrhea.

The infection may be confined to the epididymis or may even extend up to the testes, leading to orchitis.

Severe infections may lead to scrotal abscess.

Certain medications, like amiodarone, may inflame the epididymis to cause epididymitis.

This organ may secondarily get affected in infections like tuberculosis.

It is essential to treat the condition urgently.

If not treated, the following complications may occur-

  • Infection from the epididymis may spread to involve the testes, leading to orchitis.
  • Scrotal abscess
  • Infertility
  • The infection may become chronic, leading to chronic epididymitis.

Diagnosis

Diagnosis is made on the basis of symptoms. An ultra sound may be done to rule out other conditions which present with similar symptoms. These include testicular torsion, tumors of testes etc.

STD screening may be done.

Treatment

Appropriate antibiotics need to be given at the earliest. If pus is formed, it needs to be drained out surgically.

In cases where surgical drainage is not possible, the whole or part of the epididymis is surgically removed. This is called epididymectomy.

While being treated, bed rest is advised. The scrotum may be elevated by keeping a towel under it. Cold packs may be put to reduce inflammation over the affected scrotum.

Avoid sex till the treatment is complete.

Orchitis

Infection and subsequent inflammation of the testes is called orchitis.

Causes

Commonest cause of orchitis is viral infection due to mumps virus, especially if it occurs during teenage.

Bacterial orchitis usually occurs as a sequel of epididymitis, and may be due to STD or some other bacteria.

Symptoms

These are similar to those of orchitis. They include-

  • Pain and swelling over the affected scrotum.
  • Fever, nausea
  • Discharge from the penis
  • Ache in the groin region, especially while urination or voiding.

Treatment

Rest is advised. Inflammation is reduced by giving anti inflammatory drugs. Cold ice packs may be applied over the affected side.

Bacterial infections require appropriate antibiotics.

Scrotal abscess may occur as a complication of perforated appendix.