What Is the Scrotum?

Body part name. A sagging sac of the male vulva, which contains testes, epididymis, and spermatic cord.

Chinese name: scrotum
Foreign name: scrotum

Features: Easy to shrink and stretch
Health: The surface of the scrotal skin is often full of bacteria
Disease: Genital ulcer or hyperplasia, urethral discharge

Scrotum I. Physiological composition:

Scrotal testis:

Male gonads. One on each side, located inside the scrotum. The testis is a slightly flat ellipsoid with a smooth surface, divided into two sides, the front and back edges, and the upper and lower ends. The leading edge is free, the posterior edge is attached to the mesangium, and the upper part of the trailing edge is connected to the epididymis. The surface of the testicles has a tough fibrous membrane called the white membrane. The white membrane is thickened at the trailing edge, and several small septa occur in the parenchyma of the testis, which divides the parenchyma into many testicular leaflets, which are composed of 2 to 3 seminiferous tubules and testicular stroma. After the seminiferous tubules emerge from the testis, a testicular network is formed, which emits several testicular output tubes connected to the epididymis. Testes have the function of producing sperm and secreting male hormones.

Epididymis of scrotum :

Anatomical name. It is an anatomical tissue close to the upper and trailing edges of the testicle. It is about 4-6cm long and 0.4-0.5mm in diameter. Can be divided into three parts: epididymal head: the enlarged part of the epididymis; epididymal body: the oblate part of the middle of the epididymis; epididymal tail: the lower part of the epididymis. The epididymis surface has a layer of white membrane. The epididymis head is curved and coiled from the testicular output tubules. The ends of each output tubules merge into a epididymal tube. Bend back and up to form the vas deferens. The epididymis has the function of storing sperm, and secretes liquid nutritional sperm, which promotes the sperm to continue to develop, even mature, and enhances its motility. The epididymis is the most common place for male genital tuberculosis, and the induration forms in the lesion.

Scrotal spermatic cord:

The seminiferous cord is a cord that suspends the testicles and epididymis, and is formed by covering the blood vessels, lymphatic vessels, nerves, and vas deferens that enter and exit. The spermatic cord starts from the inner groin ring and travels in the groin canal. After exiting the subcutaneous ring, it enters the scrotum and ends at the posterior edge of the testis. The length is about 11 to 15 cm. When the spermatic cord passes through the inguinal canal, the superior iliac inferior ventral nerve and the inferior inferior inguinal and reproductive femoral nerves pass through. The vas deferens are located in the middle. The cranial venous plexus is located in the front and merges into 2 to 3 spermatic veins at the inner ring. It usually merges into a trunk after the peritoneum. The left internal spermatic vein returns to the left renal vein, and the right internal spermatic vein returns directly to the inferior vena cava. The spermatic lymphatic vessels collect the lymph of the testis and epididymis, which is not connected to the inguinal lymph nodes and directly flows into the iliac lymph nodes and lumbar lymph nodes.

Scrotum II, Scrotal Emergencies:

Clinical manifestations of the scrotum :

Scrotal emergencies include acute epididymitis, orchitis, acute sheath inflammation, acute scrotal infection, testicular damage, idiopathic scrotal edema, testicular torsion, and scrotal gangrene, etc., all with scrotal redness and pain as the first symptom, except for testicular damage with clear trauma Beyond history, there is no significant difference in early medical history. Only acute epididymal orchitis and acute meningitis are relatively mild in the onset and progression of symptoms compared with testicular torsion. Testicular torsion can occur at any age.

Physical examination of the scrotum :

A careful physical examination of the signs is essential for the early diagnosis of scrotal emergency. The scrotum of the testicular torsion may not be red and swollen, and the scrotal swelling can be seen when the twisting time exceeds 12 hours. The testicles were swollen and tender. The longer the torsion time, due to the severe local swelling, the boundary between the testicles and the epididymis cannot be cleared. Elevated patients with increased scrotal pain, that is, positive Prehn's sign, is a major feature of the disease. Due to spasm of the cremaster and spermatic cord torsion shortening, the testis is shifted upwards or in a mold position, and the anterior epididymis is an important manifestation of testicular torsion. Testicular epididymitis mostly occurs in adults. The affected scrotum is enlarged, the skin is red and swollen, the spermatic cord is thickened and tender, and the enlarged testicular and epididymal contours can be clearly reached. The ipsilateral testis is usually drooping and the Prehn's sign is negative. When sudden scrotal pain suddenly appears, the skin is red, swollen, shiny, hard, with erythema, blisters, and then wet, and becomes purple-black and necrosis. The accumulation of air in the diseased tissue and the twisting sound are the characteristics of scrotal gangrene.