Scrotum abscess – the encapsulated purulent center in scrotum fabrics. Can be primary or secondary, superficial or vnutrimoshonochny. Meets seldom. Develops at infection with an ater, surgical interventions and traumatic damages or is a complication of a bacterial infection in the field of a small egg and its appendage. Symptoms of abscess of a scrotum are intensive pains, hypostasis, hyperaemia and a local hyperthermia in a defeat zone. Temperature increase of a body to febrilny figures, weakness, weakness, a headache, joint and muscles pains are observed. Treatment is surgical, opening and drainage of abscess against the background of antibacterial therapy is required.
Scrotum abscess – a rare pathological state. Frequency of development is unknown, isolated cases without instructions on prevalence of a disease are mentioned in literature. Can initially arise or develop against the background of other pathological processes. The scrotum abscesses which are a complication of a sharp purulent epididimoorkhit are most often diagnosed. Despite rather superficial arrangement of the purulent center, a disease can represent difficulties during diagnostics because of the expressed edematous and infiltrative processes and the poured pains in the field of plentifully innervated soft fabrics of a scrotum, a crotch and penis. Treatment of abscess of a scrotum is performed by the general principles of purulent surgery. Medical events are held by experts in the field of andrology and urology.
Reasons and classification of abscesses of a scrotum
Taking into account localization allocate superficial (settling down in skin and blankets of body) and internal or vnutrimoshonochny (vnutriyaichkovy and intra vaginal) scrotum abscesses. Taking into account the reasons of development distinguish primary and secondary (being a complication of other pathological process) defeats. The superficial purulent centers can be both primary, and secondary. Internal abscesses of a scrotum usually have secondary character and result from spread of an infection from bodies of a scrotum, is more rare – from other anatomic areas. Hemolytic staphylococcus, golden staphylococcus or microbic associations become the activator of purulent process most often. The scrotum abscesses caused by salmonellas, brucellas, pale spirokheta, kandida and anaerobic microorganisms are less often diagnosed.
Carry the small thickness of epidermis, the increased humidity of skin of body, friable hypodermic cellulose, a large number of sweat and sebaceous glands to number of the local factors promoting development of abscesses of a scrotum. Because of proximity of an urethra and back pass on skin of a scrotum a large number of the high-virulent microorganisms capable to cause abscess gets. Features krovo-and a limfosnabzheniye of a scrotum create favorable conditions for delay of outflow of liquid and development of the expressed hypostasis against the background of thrombophlebitis and a limfostaz. The general contributing factors increasing probability of developing of abscess of a scrotum are non-compliance with rules of personal hygiene by socially unsuccessful patients, and also violations of immunity owing to chronic somatic diseases, obesity, diabetes, malignant new growths, AIDS, drug addiction and alcoholism.
Adults most often have an immediate cause of abscess of a scrotum a purulent inflammation of a small egg and its appendage. Specify a piodermiya (pustulous defeats, furuncles, an anthrax), suppuration as the cause of this pathology by an ater, open traumatic damages (chipped and cut wounds, gunshot wounds) and an infection in the field of postoperative wounds less often. Cases when scrotum abscess at adults developed at a disease Krone, paracolitis and sharp destructive pancreatitis as a result of spread of an infection on cellulose of zabryushinny space and a small pelvis are described. Children of younger age sometimes have the scrotum abscess reason a distribution of infectious process from internals in a scrotum through a nezarashchenny vaginal shoot of a peritoneum.
Symptoms and diagnosis of abscess of a scrotum
Bystry development is characteristic of abscess of a scrotum. The patient has pains, hypostasis in the field of a scrotum develops. In the next several days sharp strengthening of a pain syndrome and progressing of hypostasis is noted. Skin of a scrotum reddens, increase in local temperature is noted. Local symptoms of abscess of a scrotum are combined with the general signs of purulent process. The patient complains of weakness, weakness, head and musculoarticulate pains. Temperature increase to 38-39 degrees comes to light.
The septic option of abscess of a scrotum with rough progressing of symptomatology and the expressed system and inflammatory reactions is in certain cases observed. At infection with fungi, pale spirokhety and mikobakteriy tuberculosis the erased current with a moderate pain syndrome and temperature increase to subfebrilny figures can be observed. In the absence of treatment the break of abscess of a scrotum and further spread of an infection is possible. Sometimes because of violations of a blood-groove in skin of a scrotum there are hemorrhages with the subsequent formation of the superficial centers of an infection in the struck fabrics.
For diagnosis data of poll, external survey, laboratory analyses and tool researches are used. At survey of the patient with abscess of a scrotum considerable puffiness, local hyperaemia and a hyperthermia in the field of defeat comes to light. The scrotum is sharply painful at a palpation. On blood tests decide increase in SOE and on shift to the left. For specification of localization and a stage of abscess usually appoint ultrasonography of a scrotum. At suspicion on distribution of infectious process of a small pelvis, an abdominal cavity or retroperitoneal space use KT and MPT which allow to obtain information on a condition of several anatomic areas, to specify localization of primary center and way of spread of an infection.
Treatment and the forecast at scrotum abscess
The patient is urgently hospitalized in andrological or urological office. At early stages appoint antibacterial and resolvents. After "maturing" of an abscess carry out opening and drainage of abscess of a scrotum. At heavy destructive processes in the field of a small egg carry out an orkhiektomiya. At distribution of purulent process of other anatomic areas the volume of intervention is expanded. In the subsequent carry out bandagings, correct antibacterial therapy taking into account sensitivity of microflora.
The forecast for life at scrotum abscess usually favorable. At the long course of a disease formation of fistulas and zatek in a crotch and pararectal cellulose is possible. A rare, but dangerous complication of abscess of a scrotum is Fournier's gangrene – a lightning necrosis of fabrics of a scrotum. The probability of development of a lethal outcome at this complication according to various data fluctuates from 50 to 80%. In the remote period after abscess of a scrotum violation of functions of a small egg, appendage of a small egg and semyavynosyashchy channel with development of androgenic insufficiency or male infertility is sometimes observed.