Testicular abscess

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Abstract

In the present literature review modern view on the etiopathogenesis, clinical course, diagnosis, treatment and prognosis of testicular abscess, which is a rare disease, are described. Testicular abscess develops most often as a result of acute epididymo-orchitis (more than 80% of all cases), much rarer due to testicular inversion and injury. The etiological agent is often E. coli. The disease occurs at any age, especially in immunocompromised patients. Clinical and laboratory picture of testicular abscess has symptomatic nature and consists of local and general signs of purulent inflammation. There are no pathognomonic clinical symptoms. Testicular abscess may occur under the guise of acute inguinal and scrotal area diseases, in a quarter of patients it is characterized by inapparent clinical and laboratory course, simulating testicular tumor or tuberculous orchitis. Diagnostic difficulties are caused by nonspecific clinical and laboratory characteristics and radiation patterns, disease infrequency and a lack of awareness among physicians. Suspicion of testicular abscess arise in ineffectiveness of antibiotic therapy for acute epididymo-orchitis during the first 5-7 days of disease and makes physician to perform necessary X-ray studies. The method of choice for the testicular abscess diagnosis is ultrasound examination. The diagnostic capabilities of other radiation techniques have currently been studying. Ultrasound picture of testicular abscess depending on the disease stage is varying and does not differ from the ultrasound picture of abscess of other localization. The most difficult is differential diagnosis of abscess and testicular tumors. In diagnostically ambiguous cases, ultrasound-guided percutaneous testicle biopsy or exploratory surgery are performed. Choice of treatment method is determined by the disease stage. A variety of conservative and surgical treatment methods of the testicular abscess are applied, such as antibiotic therapy, percutaneous puncture and ultrasound-guided abscess aspiration, abscessotomy and orchiectomy. Prognosis for life is favorable with timely treatment of disease.

About the authors

A V Prokhorov

Moscow, Russia

Author for correspondence.
Email: botex@rambler.ru

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