Why Does the Scrotum Always Appear Shrunken?

Update Date: 2024-05-18 Source: Network

The skin on the surface of the scrotum has significant elasticity, and there is a layer of muscle above the testicles called the cremaster muscle. The human body can regulate itself according to temperature. When the temperature is cold, the scrotal skin and cremaster muscle will contract, reducing the area of the scrotum and elevating the position of the testicles to reduce heat dissipation. Therefore, these physiological phenomena are caused by cold stimulation, which can lead to the tightening of the scrotal skin. Additionally, a small number of scleroderma cases, as well as some connective tissue diseases and scrotal edema, can also cause the tightening of the scrotum, but the probability is relatively low.

Common clinical manifestations of scrotal diseases include acute epididymitis, orchitis, acute sheath inflammation, acute scrotal infection, testicular injury, idiopathic scrotal edema, testicular torsion, and scrotal gangrene. These conditions are typically characterized by redness, swelling, and pain in the scrotum. Except for testicular injury, which has a clear history of trauma, there are no significant differences in early clinical history among these conditions. However, the onset and progression of symptoms are relatively slower in acute epididymo-orchitis and acute sheath inflammation compared to testicular torsion, which can occur at any age.

Physical examination is crucial for the early diagnosis of acute scrotal conditions. In the early stages of testicular torsion, there may be no redness or swelling in the scrotum, but redness and swelling may become visible if the torsion persists for more than 12 hours. The testicles may appear significantly swollen and tender to the touch. In cases where the torsion has occurred for a longer period, the local swelling may be severe, making it difficult to distinguish the boundary between the testicles and epididymis. Lifting the patient's scrotum may exacerbate the pain, a sign known as Prehn's sign, which is a characteristic feature of this condition. Additionally, due to the spasm of the cremaster muscle and torsion of the spermatic cord, the testicles may shift upward or take a more anterior position, which is an important manifestation of testicular torsion.

Epididymo-orchitis, on the other hand, often occurs in adults. The affected side of the scrotum may become enlarged, with redness and swelling of the skin. The spermatic cord may also appear thicker and tender to the touch. The enlarged and painful testicles and epididymis can be felt clearly. The affected testicle often hangs down, and Prehn's sign is typically negative in this condition.