Scrotal explorations in a developing country: The pattern at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria

Abstract

Objective: To evaluate all surgeries involving exposure of scrotal contents in order to establish a pattern, if any.
Patients and methods: All consecutive patients with scrotum-related pathologies who presented to the authors over a seven-year period were
prospectively studied.
Results: Nine hundred and eighty-eight patients were studied. Their ages ranged from three days to 90 years, with a mean age of 42 years.
Indications for scrotal exploration included a wide range of paediatric, general surgical and urological pathologies. The commonest included herniae in 393 (39.8%) patients, prostatic carcinoma in 192 (19.4%), hydrocoele in 182 (18.4%) and varicocoeles in 99 (10.0%) patients.
The commonest surgical procedures were herniorrhaphies in 217 (22.0%) patients, orchidectomies in 239 (24.2%) patients, herniotomies in 212
(21.5%) patients, hydrocoelectomies in 155 (15.7%) patients, varicocoelectomies in 99 (10.0%) patients and orchidopexies in 52 (5.3%) patients. The commonest complications of scrotal exploration included scrotal oedema in 547 (55.4%) patients and wound infection in 63 (6.4%) patients. The approaches used were trans-scrotal in 392 (39.7%) patients and trans-inguinal in 596 (60.3%) patients. In 344 (34.8%) patients, both the left and the right hemiscrota were explored, while 323 (32.7%) and 321 (32.5%) had only right and only left hemi-scrotal exploration respectively.

Conclusion: Scrotal exploration incorporates many surgical procedures which are carried out on males of all age groups for various inguino-scrotal
conditions. Complications are common, and since very vital organs are involved, surgeons should be well trained in both trans-scrotal and transinguinal approaches to avoid embarrassing consequencies.