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At least 19 recordsLinked to original sources
PubMed1998

Unilateral suprainguinal ectopic scrotum: the role of the gubernaculum in the formation of an ectopic scrotum.

A rare case of ectopic scrotum is described together with a review of the literature and a discussion of the embryological role of the gubernaculum in the formation and location of normal and ectopic scrota. We identified 16 reported cases of a suprainguinal ectopic scrotum, 4 cases of a femoral ectopic scrotum, 26 cases of penoscrotal transposition, and 19 cases of a perineal (accessory) scrotum. Although the gubernaculum is a prerequisite for the ultimate location of both the testis and scrotum, its role is complicated by the subsequent differential growth of the labioscrotal folds in which the gubernaculum is stabilized. If this interaction is disturbed, the result may be a suprainguinal ectopia, penoscrotal transposition or a perineal scrotum. A femoral ectopic scrotum, unlike the above, is the result of an aberrant gubernacular stabilization. While the etiology of these malformations is likely to be multifactorial, the existence of an inbred strain of rats characterized by a high incidence of an ectopic scrotum suggests a genetic component to this anomaly.

Animals↗
PubMed2004

New phenotype of accessory scrotum with perineal lipoblastoma: coexistence of midperineal and lateral accessory scrotums.

We present the extremely rare phenotype of an accessory scrotum with an associated lipoblastoma. There was a coexistence of midperineal and lateral types. To our knowledge, this phenotype has never been reported. The lipoblastoma, which arose in the perineum, divided the moving labioscrotal swelling into three parts during early fetal life. This resulted in the specific anomaly in this patient.

Biopsy, Needle↗
PubMed1999

The evolution of the scrotum and testicular descent in mammals: a phylogenetic view.

The adaptive significance of the scrotum and the evolution of the descent of the testicles and epididymis have been a focus of interest among biologists for a long time. In this paper we use three anatomical character states of the scrotum and descensus: (1) testicles descended and scrotal; (2) testicles descended but ascrotal; (3) testicles not descended (testicondy). These states are then mapped on an up to date phylogeny of the Mammalia. Three main points arise out of this mapping procedure: (1) the presence of a scrotum is either primitive in extant Mammalia or primitive within eutherian mammals except Insectivora; (2) evolution has generally proceeded from a scrotal condition to progressively more ascrotal; (3) loss of testicular descensus is less common in mammalian evolution than is loss of the scrotum. In the light of these findings we discuss some current hypotheses regarding the origin and evolution of the scrotum. We find that these are all incomplete in so far as it is not the presence of the scrotum in various mammal groups that requires explaining. Instead, it is the reverse process, why the scrotum has been lost in so many groups, that should be explained. We suggest that the scrotum may have evolved before the origin of mammals, in concert with the evolution of endothermy in the mammalian lineage, and that the scrotum has been lost in many groups because descensus in many respects is a costly process that will be lost in mammal lineages as soon as an alternative solution to the problem of the temperature sensitivity of spermatogenesis is available.

Animals↗
PubMed2001

Blunt trauma to scrotum in men with spinal cord injury after they had completed rehabilitation in a spinal unit.

STUDY DESIGN: A report of three men with spinal cord injury (SCI) who sustained blunt trauma to scrotum after they had completed rehabilitation in the spinal unit. OBJECTIVES: To raise awareness amongst health professionals regarding: (1) mechanism of scrotal trauma in men with SCI (2) need for prompt assessment of scrotal injury (3) measures to be taken by men with SCI and their carers to prevent injury to the scrotum. SETTING: Regional Spinal Injuries Centre, Southport, England. CASE REPORTS: (1) A 31-year-old with C-6 tetraplegia sustained traumatic haematocele as he squashed his right testis while he jumped on to a toilet seat in a hurry for bowel movement. (2) A 28-year-old male with T-7 paraplegia sat on his left testis while transferring on to a car seat. (3) A boxer dog jumped on to the scrotum of a 40-year-old male with T-8 paraplegia, while he was lying on his bed. CONCLUSIONS: Men with SCI are at high risk of sustaining trauma to scrotum during transfers. The scrotum may be squashed by the weight of the body during transfers, or the scrotum may be trapped between the thighs or under the torso. Men with SCI or their carers should check after each transfer that the scrotum is not trapped between the thighs or under the torso. The health professionals should encourage men with SCI to update their transfer skills at regular intervals in order to prevent trauma to the scrotum during transfers. Blunt trauma to scrotum requires prompt evaluation by ultrasonography so that appropriate treatment can be instituted without delay.

Accidents, Traffic↗
PubMed1996

Contribution of the scrotum and testes to scrotal and testicular thermoregulation in bulls and rams.

A novel model was used to determine the role of the scrotum and testes in scrotal/testicular thermoregulation in bulls and rams. Eleven yearling bulls and 12 yearling rams were used at an ambient temperature of 15 degrees C. The distal lateral aspects and entire ventral part of the scrotum were incised under caudal epidural analgesia (xylazine, 0.07 mg ml-1). Both testes were withdrawn from the scrotum, the vaginal tunic was removed and one testis was replaced in the scrotum. Surface and internal temperatures were measured with infrared thermography and needle thermocouples, respectively. Temperature gradients (difference in temperature from top to bottom; degree C) for bulls and rams, respectively, were: scrotal surface (with replaced testis) 2.1 and 3.5; scrotal surface (without testis) 2.5 and 3.6; scrotal subcutaneous (with replaced testis) 1.0 and 0.7; testicular subtunic (without scrotum) -0.7 and -0.3; deep intratesticular (with scrotum) -0.2 and -0.6; and deep intratesticular (without scrotum) -0.5 and -0.5. Results supported the hypotheses that the scrotum has a positive temperature gradient (warmer at the top than the bottom) and that the testis has a negative temperature gradient (warmer at the bottom than the top). These opposing gradients apparently complement one another, resulting in a relatively uniform intratesticular temperature, below body core temperature, that is essential for normal sperm production. The scrotum substantially increased intratesticular temperature, but scrotal surface temperature was not significantly affected by the presence of a testis.

Animals↗
PubMed1987

[The accessory scrotum. Apropos of 2 cases].

The authors report two new cases of accessory scrotum. It is an exceptional pathology. The review of the literature allowed to collect thirteen other cases. The aspect of accessory scrotum was a soft mass with scrotal skin and no content. All were located on perineal area; on the midline for ten, lateral to the raphe for four (two on the left and two on the right). Both testes were palpable in the normal scrotum. There was no polyorchidism. For all but five, the accessory scrotum was a single anomaly. Five children presented another genital problem with for four of them a second infrequent scrotal malformation (bifid scrotum or peno-scrotal transposition). Surgical treatment is easy. Histologic examination shows a true scrotal skin with muscular fibers in subcutaneous tissue, like tunica dartos. The "tumor" contains an homogeneous fat tissue. The origin of accessory scrotum is not clear. It does not seem to be a teratoma. Probably it is the result of abnormal migration with a division of labio-scrotal swellings. It is not the same as ectopic scrotum, in which localization is variable, testis is present in the abnormal scrotum or its area and in which there is only one opposite half-scrotum in its normal place.

Humans↗
PubMed1972

The influence of deep body and skin temperatures on thermoregulatory responses to heating of the scrotum in pigs.

1. The temperature on the surface of the pig's scrotum was increased by circulating water through a pad held over the scrotal surface while the animal was lightly restrained.2. At an ambient temperature of 25 degrees C there was no change in respiratory frequency even when the scrotum was heated to 42 degrees C, but peripheral blood flow did increase and body temperature fell. At 30 degrees C ambient temperature, respiratory frequency increased when the scrotum was warmed to 42 degrees C. At an ambient temperature of 32 degrees C, the frequency increased at a scrotal temperature of 40 degrees C and was even higher when the scrotum was 42 degrees C, but body temperature did not fall.3. At a constant ambient temperature the effect on respiratory frequency of heating the scrotum to a given temperature depended on the skin temperature of the trunk which was modified by means of a coat through which water was circulated.4. In a cold environment, heating the scrotum was accompanied by a fall in body temperature, the arrest of shivering and a decline in oxygen consumption.5. Cooling a thermode in the hypothalamus or over the spinal cord inhibited the increase in respiratory frequency and peripheral blood flow caused by heating the scrotum. Warming either thermode potentiates the effect of heating the scrotum.

Animals↗
PubMed2000

Measurement of scrotum and testis size of unrestrained captive cotton-top tamarins (Saguinus oedipus oedipus).

Reproduction is restricted to a small number of animals within both captive and wild groups of callitrichid monkeys (marmosets and tamarins). Sexual development of nonbreeding group members might differ from that of active breeders. Measurements of physical growth typically involve animal handling. However, capture and restraint of callitrichid monkeys can disrupt natural behaviors and physiology. This study introduces a method for estimating size of external genitalia by measuring frontal scrotum width of unrestrained cotton-top tamarin males. We examined whether scrotum width was a reliable indicator of testis size, and whether the method provided information useful for comparisons of growth and development among individuals. Animals were lured to a standardized position, and maximum width of the scrotum was systematically compared to a card with a series of rectangles graded in 1 mm increments. Card measures were validated with caliper measurements of scrotum width and testicle dimensions. Regressions of testes dimensions measured by caliper on scrotum width measured by card were between 82 and 93%, suggesting that measures of frontal scrotum width provide consistent estimates of relative testis sizes. The period of rapid growth ended by roughly two years of age, after which scrotum size did not differ from that of breeding males.

Animals↗
PubMed1996

[Accessory scrotum with lipoma: a case report].

A newborn male infant was referred to our clinic because of anomalies of external genitalia. The infant was born at term after a normal pregnancy and delivery, and was appropriate for gestational age. A tumor mass covered with scrotum-like skin on its tip was noticed in the right side of perineum between the scrotum and anus. The raphe, which ran along the midline at the penis and the normal scrotum, circumscribed the right side of this structure. Both testes had descended into the scrotum. The condition was associated with incomplete penoscrotal transposition. There was no other urological anomaly including lower urinary tract. Histological findings of the tumor indicated perineal lipoma, and the scrotum-like portion was diagnosed as an accessory scrotum. Thirty-one report cases of the accessory scrotum including our own were reviewed and discussed.

Genital Neoplasms, Male↗
PubMed2003

Accessory scrotum attached to a perineal lipoma in an adult male.

Accessory scrotum is a condition in which a scrotum is located in the perineal region, in addition to the presence of normally located primary scrotum, testes and penis. The condition is extremely rare and the majority of reported cases have been diagnosed in infants. Herein, we present a case of accessory scrotum attached to a perineal lipoma in a 40-year-old man. The perineal mass was present at birth and grew very slowly over the years. There were no other congenital abnormalities or problems related to this anomaly. The case was easily managed by complete excision of the accessory scrotum and perineal lipoma. Gross and microscopic examination of the surgical specimen revealed an accessory scrotum attached to an encapsulated perineal lipoma. The present case demonstrates an adult prognosis of a patient born with this type of abnormality. To our knowledge, it is the first case of its kind to be reported in the literature.

Adult↗
PubMed2003

Critical validation of colour Doppler ultrasound in diagnostics of acute scrotum in children.

Acute scrotum in children is generally a symptom. Several pathologies of the testis, scrotum or groin may cause it, including inflammatory as well as ischaemic processes. Testicular torsion with ischaemia of the testis is an emergency requiring prompt surgical intervention. Even experienced paediatric surgeons and urologists may have difficulties differentiating an ischaemic from an inflammatory aetiology solely on the basis of clinical signs and symptoms. In cases of aetiologic uncertainty, operative exploration has to be performed to rule out ischaemia, which led in the past to a high rate of surgery. More recently, colour Doppler ultrasonography (CDUS) has become an imaging modality for the examination of the acute scrotum with the purpose of detecting ischaemia, thus reducing the need for explorative surgery. In this study we examined the reliability of CDUS, comparing the sonographical diagnoses with both the intraoperative findings and the clinical course. We present here 132 consecutive cases of acute scrotum in children, who were admitted from 01/98 through 10/02 to our hospital. All patients underwent CDUS. Patients with ultrasonographic signs of ischaemia of the testis (group A) and patients with demonstrated perfusion and suspicious or severe clinical symptoms (group B) were operated immediately. Patients with demonstrated perfusion without suspicious or severe symptoms (group C) were treated conservatively. Thirty-eight patients (28.8%) were treated operatively. Eleven cases of testicular torsion in group A (12 pat.) could be confirmed intraoperatively, in one case there was no testicular torsion but a severe inflammation of the testis with torsion of the appendix testis. In group B (26 pat.) operative exploration revealed one case of testicular torsion. In group B two cases of sonographically suspected torsions of the appendix testis also emerged as epididymitis intraoperatively. In the other cases postoperative diagnosis was in agreement with the preoperative CDUS. The clinical course of 94 conservatively treated patients (71.2%) (group C) confirmed in all cases a non-ischaemic aetiology. There was a total of 12 cases (9.1%) where acute scrotum was caused by testicular torsions. This relatively low rate underlines the necessity to differentiate between ischaemic and other aetiologies, thus avoiding operation in many patients. 71.2% of our patients could be treated conservatively. However, it is essential to exclude an ischaemic cause before opting for conservative therapy. Even though CDUS is a very valuable diagnostic tool in this sense, this exclusion cannot be ensured in every case and is highly dependent on the expertise and technique of the investigator. Therefore in cases with any doubts an operative exploration has to be performed to avoid the most dreaded complication in the treatment of acute scrotum.

Acute Disease↗
PubMed1991

[Congenital perineal lipoma with accessory scrotum: a case report].

A tumor mass covered with scrotum-like skin on its tip was found on the perineal region of 3-year-old boy since his birth. The mass was diagnosed as congenital lipoma, which was resected, because of its gradual enlargement. Histopathological findings of the tumor indicated perineal lipoma, and the scrotum-like portion was diagnosed as an accessory scrotum. In the Japanese literature, 7 congenital perineal lipomas (6 males, 1 female) have been reported and all male cases except 1 case (no description about scrotum) were accompanied with an accessory scrotum. We conclude that there may be a close relationship between congenital perineal lipoma and accessory scrotum.

Child, Preschool↗
PubMed1998

[Scrotum exfoliative dermatitis with ulcers associated with treatment of acute promyelocytic leukemia with all-trans retinoic acid].

All-trans retinoic acid (ATRA) induces complete remission (CR) in most cases of acute promyelocytic leukemia (APL). Toxicity of ATRA has been shown to be mild and consist of headache, dry skin, dermatitis, gastrointestinal disorders, and hypertriglyceridemia. We report three patients with APL treated with ATRA in combination with chemotherapy, who developed scrotum exfoliative dermatitis with ulceration. Their age was 33 years (range, 25 to 37). All three cases developed scrotum erosions, and many small ulcers after 9 to 17 days of ATRA treatment. The scrotum exfoliative dermatitis with ulceration occurred repeatedly, but gradually resolved in about 8 weeks time. They developed no dryness of the lip or skin apart from the scrotum. All three cases continued to receive 45 mg/m2 of ATRA daily throughout induction therapy, and achieved CR. We suspected the scrotum exfoliative dermatitis with ulceration to be a side effect of ATRA. The scrotum lesions, which have been already reported may be common in patients receiving ATRA.

Adult↗
PubMed2001

Clinical study of scrotum scintigraphy in 49 patients with acute scrotal pain: a comparison with ultrasonography.

The significance of scrotum scintigraphy in differentiating acute testicular torsion from acute orchiepididymitis was evaluated. In this report, 49 patients with acute scrotal pain were examined with radionuclide scrotum scintigraphy and ultrasonography in parallel for comparison. Of 37 patients with decreased radioactivity in the abnormal side scrotum, 35 were diagnosed with testicular torsion surgically and the other 2 were diagnosed with indirect inguinal hernia. Only 17 among the 35 patients were diagnosed by ultrasonography as having testicular torsion. The remaining 12 patients with increased radioactivity in the abnormal side of the scrotum were all diagnosed with orchiepididymitis through conservative treatment and clinical follow-up, but only 8 of the 12 were correctly and exactly diagnosed by ultrasonography. In the process of diagnosing acute scrotal pain, radionuclide scrotum scintigraphy has obvious advantage over ultrasonography. It also has the advantage of being simple, fast and accurate but without any detrimental effect on the human body.

Adolescent↗
PubMed1997

Contribution of the scrotum, testes, and testicular artery to scrotal/testicular thermoregulation in bulls at two ambient temperatures.

The objective of this study was to determine the contribution of the scrotum, testes, and the testicular artery to scrotal/testicular thermoregulation in bulls at two ambient temperatures. Crossbred beef bulls, 1.5 years of age, were placed in controlled environment chambers at ambient temperatures of 15 degrees C (n = 5) or 25 degrees C (n = 6). The distal lateral aspects and entire ventral part of the scrotum was incised under caudal epidural anaesthesia (xylazine, 0.07 mg kg-1. Both testes were withdrawn from the scrotum and then replaced and maintained by clamping the scrotal incisions with towel clamps. One testis was randomly chosen to be the exposed testis and was withdrawn prior to temperature measurements. Surface and internal temperature were measured with infrared thermography and needle thermocouples, respectively. Temperature gradients (degree C; difference in temperature from top to bottom at 15 and at 25 degrees C) were: scrotal surface (with testis), 1.5 and 1.3; scrotal surface (without testis), 2.1 and 1.6; surface of exposed testis, -0.6 and 0.0; sub-tunic of exposed testis, -2.2 and -0.6; intratesticular (covered testis), 0.0 and 0.4; and intratesticular (exposed testis), -1.3 and 0.4. The scrotum markedly affects testicular temperature but the testes have limited influence on scrotal surface temperature. The bovine scrotum and testes have opposing temperature gradients that complement one another, resulting in a relatively uniform intratesticular temperature. These temperature gradients are attributed in part to the testicular artery, which goes from the top of the testis to the bottom, divides into several branches and ramifies dorsally and laterally before entering the testicular parenchyma. Intra-arterial temperatures (measured with needle thermocouples) were lower (P < 0.05) where the artery entered the testis than at both the bottom and top of the testis for both the covered (31.7, 33.4 and 34.3 degrees C) and exposed testis (29.6, 32.0 and 32.5 degrees C) at an ambient temperature of 15 degrees C. Temperature differences were similar, but less pronounced, at 25 degrees C (covered testis, 34.8, 36.3 and 36.5 degrees C; exposed testis, 32.4, 33.5, 33.9 degrees C). Results supported the hypothesis that blood within the testicular artery has a similar temperature at the top of the testis (just ventral to the testicular vascular cone) compared with the bottom, but subsequently cools before entering the testicular parenchyma.

Animals↗