Scrotal Pain
This may be due to lesions on the scrotal skin, within the scrotum, or may, rarely, be due to referred pain.
Causes
Skin
Figure 56 Fournier’s scrotal gangrene.
This 64-year-old diabetic presented with scrotal pain and high pyrexia. Within a few hours of admission, black necrotic areas appeared on the scrotum. Treatment was with antibiotics, wide excision of all necrotic tissue, the wound being left open to heal by second intention.
Internal Scrotal Swellings
History
Skin
The patient may have noticed a skin lesion, which is itchy, sore or painful. In the elderly, confused and incontinent, pain and soreness may be due to the irritant effect of faeces and urine with superadded infection. Previous history of a superficial swelling may suggest an infected sebaceous cyst. There may be a history to suggest contact dermatitis. Painful vesicular lesions may suggest herpes. Behçet’s syndrome may cause painful ulcerative lesions of the scrotum and the patient may also have similar lesions on the penis. Fournier’s gangrene usually has acute onset in a young, healthy male with rapid progression to gangrene of the skin. There is often absence of a discernible cause.
