Anatomy of inguinal canal and scrotum
- The inguinal canal is a 5-6 cm long, 1-2 cm wide and 1-2 cm deep passage in the lower abdominal wall.
- It allows the spermatic cord in males and the round ligament in females to pass through.
- The scrotum is a double-layered sac of skin and muscle that contains the testes in males.
- The layers of the scrotum are the skin, dartos muscle, cremaster muscle, tunica vaginalis, and the tunica albuginea.
Causes of inguinoscrotal swelling
- Hydrocele: collection of fluid in the tunica vaginalis.
- Varicocele: enlargement of the pampiniform plexus of veins.
- Hernia: protrusion of an organ or tissue through a weakened area in the abdominal wall.
- Testicular tumor: a growth in the testes.
- Epididymitis: inflammation of the epididymis.
- Orchitis: inflammation of the testes.
- Hydrocoele of the cord: collection of fluid in the spermatic cord.
Inspection of inguinoscrotal swelling
- Observe the swelling for its size, shape, color, and texture.
- Check for any tenderness, redness, or swelling.
- Note any abnormalities in the scrotum or testes.
Palpation of inguinoscrotal swelling
- Palpate the swelling for its consistency, mobility, and tenderness.
- Check for any masses or nodules.
- Note any abnormalities in the scrotum or testes.
Transillumination test
- Shine a bright light through the swelling.
- If the swelling transilluminates, it may indicate a hydrocele or other fluid collection.
- If the swelling does not transilluminate, it may indicate a solid mass such as a tumor.
Differentiation of inguinoscrotal swellings
- Hydrocele: usually painless, transilluminates, and is smooth and shiny.
- Varicocele: usually painless, transilluminates, and is a network of veins.
- Hernia: usually painful, does not transilluminate, and is a bulge in the scrotum.
- Testicular tumor: usually painful, does not transilluminate, and is a hard, irregular mass.
- Epididymitis: usually painful, does not transilluminate, and is a tender, swollen epididymis.
- Orchitis: usually painful, does not transilluminate, and is a tender, swollen testes.
Role of ultrasound and Doppler studies
- Ultrasound: can help diagnose hydrocele, varicocele, and other fluid collections.
- Doppler studies: can help diagnose varicocele by showing the flow of blood in the pampiniform plexus of veins.
Types of inguinoscrotal swellings
- Hydrocele: a collection of fluid in the tunica vaginalis.
- Varicocele: an enlargement of the pampiniform plexus of veins.
- Hernia: a protrusion of an organ or tissue through a weakened area in the abdominal wall.
- Testicular tumor: a growth in the testes.
- Epididymitis: inflammation of the epididymis.
- Orchitis: inflammation of the testes.
Causes of inguinoscrotal swellings
- Hydrocele: usually due to a blockage in the lymphatic vessels of the testes.
- Varicocele: usually due to a blockage in the spermatic veins.
- Hernia: usually due to a weakness in the abdominal wall.
- Testicular tumor: usually due to a genetic mutation.
- Epididymitis: usually due to a bacterial infection.
- Orchitis: usually due to a viral infection.
Clinical features of inguinoscrotal swellings
- Hydrocele: usually painless, transilluminates, and is smooth and shiny.
- Varicocele: usually painless, transilluminates, and is a network of veins.
- Hernia: usually painful, does not transilluminate, and is a bulge in the scrotum.
- Testicular tumor: usually painful, does not transilluminate, and is a hard, irregular mass.
- Epididymitis: usually painful, does not transilluminate, and is a tender, swollen epididymis.
- Orchitis: usually painful, does not transilluminate, and is a tender, swollen testes.
Pathology of inguinoscrotal swellings
- Hydrocele: a collection of fluid in the tunica vaginalis.
- Varicocele: an enlargement of the pampiniform plexus of veins.
- Hernia: a protrusion of an organ or tissue through a weakened area in the abdominal wall.
- Testicular tumor: a growth in the testes.
- Epididymitis: inflammation of the epididymis.
- Orchitis: inflammation of the testes.
Investigations for inguinoscrotal swellings
- Ultrasound: can help diagnose hydrocele, varicocele, and other fluid collections.
- Doppler studies: can help diagnose varicocele by showing the flow of blood in the pampiniform plexus of veins.
- CT scan: can help diagnose hernia and other abnormalities in the abdominal wall.
- MRI: can help diagnose testicular tumors and other abnormalities in the testes.
Complications of inguinoscrotal swellings
- Hydrocele: can lead to a collection of fluid in the scrotum.
- Varicocele: can lead to a collection of blood in the scrotum.
- Hernia: can lead to a protrusion of an organ or tissue through a weakened area in the abdominal wall.
- Testicular tumor: can lead to a growth in the testes.
- Epididymitis: can lead to inflammation of the epididymis.
- Orchitis: can lead to inflammation of the testes.
Management and treatment of inguinoscrotal swellings
- Hydrocele: usually treated with a surgical procedure to remove the fluid collection.
- Varicocele: usually treated with a surgical procedure to remove the varicocele.
- Hernia: usually treated with a surgical procedure to repair the weakened area in the abdominal wall.
- Testicular tumor: usually treated with a surgical procedure to remove the tumor.
- Epididymitis: usually treated with antibiotics to treat the infection.
- Orchitis: usually treated with antibiotics to treat the infection.
Homoeopathic therapeutic medicines for inguinoscrotal swellings
- Hydrocele: Calcarea carbonica, Calcarea phosphorica.
- Varicocele: Belladonna, Lachesis.
- Hernia: Calcarea carbonica, Sepia.
- Testicular tumor: Calcarea carbonica, Calcarea phosphorica.
- Epididymitisitis: Belladonna, Lachesis.
- Orchitis: Belladonna, Lachesis.