Evaluation of the Painless Scrotal Masses

Kim, Hyung Jee; Lee, Gil Ho

Abstract

Painless scrotal masses are clinical syndromes composed of variable causes such as benign disease and testicular cancer. So, the methods of treatment are differ from each causes and in the case of testicular cancer, as its painless nature, the delayed treatment can be alter the methods of treatment and the prognosis. During 21 months, between June 1994 and March 1996, we evaluated the confirmed diagnosis, the method of treatment, the diagnostic method and the distribution of age from the 125 cases of 109 patients who are admitted to the hospital from the painless scrotal mass and underwent surgical treatment and pathologic typing, retrospectively. Of the 125 cases, 57 cases (46%) were below 20 years old and communicating hydrocele was most common case (51case) and 66 cases were age of over 20 years old. In 66 cases, 17 cases (25%) were chronic epididymitis, 15 cases (22.1%) were noncommunicating hydrocele and 9 cases (13.2%) were varicocele, respectively. Malignant neoplasm was distributed to the 1 case of pediatric group and 3 cases (4.4%) of adult group. Transillumination test, generally, revealed negative or equivocal finding except to hydrocele. On the ultrasonographic test (35 cases). most cases were identical or correspond to the postoperative diagnosis and 1 case was misdiagnosed (accuracy rate, 97.1%) but in the case of inflammatory disease, it was difficult to differentiate between specific and non-specific infection. We conclude that the work up for the painless scrotal mass should begin with careful physical examination, and when the physical examination, scrotal transillumination and scrotal ultrasonography show the equivocal finding, surgical exploration with inguinal incision will be necesssary to prevent sequelae or complication of malignant disease.