The scrotum is the sac of skin and other tissues that supports the testicles outside of the pelvis. Its main function is to protect the testicles or testicles by allowing them to remain below body temperature. The testes are more functional at lower temperatures.
Possible scrotal injury or scrotal disease. However, most scrotal symptoms are related to the internal structures of the scrotum. Damage or trauma to the testicles or epididymis can cause swelling and pain in the scrotum .
The scrotum is part of the male anatomy. This is a musculocutaneous sac that hangs in front of the pelvis between the legs. The scrotum is divided into two parts by the scrotal septum . In most men, one testicle is located on each side of the scrotal septum. Usually one side of the scrotum falls slightly lower than the other.
The outer layer of the scrotum is made of leather. This skin is usually a darker color than the surrounding skin. Under the skin is the dartos muscle or tunica dartos . Tunica dartos helps regulate testicular temperature by contracting to reduce scrotal surface area and reduce heat loss, or by relaxing to increase scrotal surface area to help with cooling.
Another muscle within the scrotum is the cremaster muscle. There are two of those muscles, one on each side. Each muscle covers the testicles and the spermatic cord and enters the pelvis through the inguinal canal . The function of the cremasters is to raise or lower the testicles. It also helps keep the testicles at a suitable temperature.
The cremasteric reflex is a reaction to gentle stroking of the inner thigh. This causes the muscles to contract and the testicles to move upward. Some men may also voluntarily contract the cremasters muscles.
The spermatic cord provides blood supply to the testes, vas deferens, and cremation muscle. It also contains nerves and lymphatic vessels that connect to the internal structures of the scrotum.
The scrotal septum divides the scrotum into two chambers. It is an extension of the perineal suture , a line of tissue that runs from the anus through the perineum and up the midline of the penis . When the testicles descend in infancy, there is usually one testicle on each side of this septum.
There are a number of possible anatomical variations in the scrotum. In general, these variations are quite rare. However, they include :
- Accessory scrotum: Accessory scrotum that usually develops beyond the perineum to the anus. The accessory scrotum does not contain testicles. This usually does not cause problems with the underlying scrotum.
- Forked scrotum: This is when there is a cleft in the middle of the scrotum. This happens when there is not enough testosterone in an early stage of development for the scrotum to fuse. A split scrotum often occurs in conjunction with hypospadias .
- Ectopic Scrotum – The normal scrotum is found elsewhere.
- Penoscrotal transposition: when the penis and scrotum are not positioned correctly with each other. The penis can be under the scrotum (complete transposition) or in the middle of the scrotum (partial transposition).
The function of the scrotum is to protect the testicles and keep them at a suitable temperature. The scrotum performs this function by keeping the testicles out of the body and regulating their proximity to the body. In order for the testes to produce sperm efficiently, a lower temperature than core temperature is required. If necessary, the cremaster muscles can fully retract the testicles into the pelvis.
Several diseases can affect the scrotum and the structures it protects. Specifically in the scrotum, cellulitis is a type of bacterial infection of the skin. It can occur on the skin of the scrotum, causing pain and swelling.
A hydrocele occurs when fluid builds up around the testicles. Non-inflammatory edema is the accumulation of fluid in the scrotum that is not associated with swelling of the scrotal wall or hydrocele. This type of fluid can build up in people with medical conditions such as heart failure or liver failure.
A hematocele is a concern similar to a hydrocele, except that the fluid that collects around the testicles is blood. This usually happens after trauma or surgery. Similarly, with a varicocele , the veins in the scrotum become swollen. For many people, this does not cause any symptoms and does not require treatment.
Cryptorchidism occurs when one or both testicles do not descend into the scrotum. It can recover spontaneously. However, if this does not happen, orchiopexy surgery may be required to allow the testicle to descend. An undescended testicle can affect fertility.
Some sexually transmitted diseases can also affect the skin of the scrotum or its internal structures.
Other conditions that cause symptoms in the scrotum are actually related to the testicles or the epididymis. Testicular torsion is one of the few scrotal emergencies. This happens when the testicles rotate around the spermatic cord, causing a loss of blood supply. Rapid surgical repair may be required to preserve the affected testicle.
A spermatocele is when a fluid-filled sac forms in the epididymis. Epididymitis refers to an infected or inflamed epididymis, and orchitis refers to an infected or swollen testicle. Finally, testicular cancer can cause swelling and pain in the scrotum.
Symptoms affecting the scrotum are relatively nonspecific. This means that, at first glance, many different conditions may appear the same. Therefore, an exam is often required to diagnose the cause of scrotal pain or swelling.
Usually the first method of diagnosing problems with the scrotum is an ultrasound. If conventional ultrasound is not effective, contrast ultrasound can be used. Magnetic resonance imaging (MRI) with or without contrast can also be used to diagnose conditions that affect the scrotum.