December 11, 2011

Scrotal Pyocele

Gray-scale and color Doppler US images of the testicle shows a complex fluid collection (stars) around the testicle and marked scrotal skin thickening. The epididymis is edematous with increased flow (image not shown).

Facts: Scrotal Pyocele
  • Also known as scrotal abscess
  • Can be superficial (from infected hair follicles, wound) or intrascrotal
  • Causes: epididymitis, TB, instrumentation, neurogenic bladder, chronic catheter indwelling, spread from intraabdominal infection (i.e., appendicitis)
  • Intrascrotal abscess requires surgical drainage
  • US is the modality of choice
  • Complex-appearing fluid around the testicle
  • Scrotal skin thickening with hyperemia
  • Evidence of causes such as epididymitis or others
  • Based on imaging, it is difficult to distinguish pyocele from hematocele
1. Siegel MJ. Pediatric Sonography, 2010.
2. Resnick MI, Novick AC. Urology Secrets, 3rd ed, 2003.

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