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Atallah A. Shaaban<br />
81<br />
<strong>Basic</strong> <strong>Urology</strong><br />
Examination of the Testis and Scrotum<br />
THE SCROTUM<br />
- A muscular out-pouching of the lower part of the anterior<br />
abdominal wall.<br />
- Muscles of scrotum and spermatic cord contract and relax moving<br />
the testis closer or farther away from the body to control the<br />
temperature of the testis.<br />
- Scrotal edema may be localized or a part of generalized edema:<br />
acute (insect stings, angioneurotic, trauma), chronic (heart failure,<br />
renal failure).<br />
- Fournier's gangrene (Necrotizing fasciitis):<br />
Acute scrotal inflammation:<br />
Rapid onset of gangrene followed by sloughing.<br />
Total absence of any of the usual causes of gangrene.<br />
Fever, tachycardia and hypotension.<br />
Crepitus, swelling and erythema.<br />
- Sebaceous cysts are frequently seen in scrotum: multiple, small.<br />
- Carcinoma: fungating mass or ulcer.<br />
- The scrotal skin may be anchored anteriorly by gumma and<br />
posteriorly by tuberculosis of the testis.<br />
- Cremasteric reflex:<br />
Stimulus: light pinprick is applied to the medial thigh.<br />
It tests segments L 1 , L 2 .<br />
Response: homolateral contraction of cremasteric muscle<br />
with gradual elevation of the testis.<br />
- Scrotal reflex:<br />
Stimulus: stroking of perineum or by applying ice cube to scrotum.<br />
Response: contraction of dartos muscle.
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