关键词: 内镜, 阴囊, 精索扭转, 附睾, 诊断

Abstract:

Objective：To evaluate the safety and efficacy of scrotoscope in diagnosis and treatment of testicular and epididymal diseases. Methods:From September 2010 to March 2012, a total of 75 patients, aged 15-64 years (mean age is 42.4 years) were included in this study. Based on ultraso-nagraphy before surgery, 12 cases were diagnosed as testicular torsion and 63 cases were diagnosed as epididymal mass. All the patients underwent scrotoscope examination or scrotoscope epididymectomy. A small scrotal incision of 1.0 cm was performed. Bluntly dissection was then performed through the scrotal layer until the tunica sac was disclosed. We used cystoscope or resectoscope as scrotoscope. Keeping the drip fusion of isotonic solution inflowing, the scrotum was maintained appropriate distended. The tunica sac wall including parietal and visceral tunica was checked. The testis, epididymis was then examined from the anterior, posterior and both lateral aspects to find out any potential pathology. The operation time of scrotoscope, postoperative complications, surgery record, ultrasound and pathology results were collected from medical record. Visual analog pain scale (range from 0 points to 10 points, 0 represent no pain, 10 represent the most severe pain) was used to assess scrotal pain. The postoperative complications, recurrence and pain relief were evaluated, the accuracy rates of the diagnosis was compared between scrotoscope and ultrasound based on pathology results.Results:  All the patients were successfully performed scrotoscope except one because of inflammatory adhesion. The average time of the operation was 34.3±5.8 minutes, and no serious complications, such as severe edema, hematoma, testicular hydrocele and wound infection occurred. The accuracy rate of scrotoscope and ultrasound for the diagnosis of testicular torsion was 100% vs. 66.7%, and the accuracy rate of scrotoscope and ultrasound for the diagnosis of epididymal mass was 76.2% vs. 58.7%. In the study, 63 patients received scrotoscope epididymectomy, the visual analogue pain score before surgery was 7.1±0.8, 6 months after operation, and the pain score was 2.4±0.6. Conclusion: Scrotoscope is safe. There are no serious complications such as severe edema, hematoma, testicular hydrocele and wound infection occurred. Scrotoscope is superior to ultrasound for diagnosis of testicular torsion and epididymal mass. Scrotoscope epididymectomy is effective for pain relief, especially for patients with epididymal cyst.

Key words: Endoscopes, Scrotum, Spermatic cord torsion, Epididymis, Diagnosis