目的：评估阴囊镜在睾丸扭转和附睾肿块诊断和治疗中的安全性和有效性。方法：对中南大学湘雅二医院泌尿外科2010年9月至2012年3月， 行阴囊镜检或阴囊镜下附睾肿块等离子电切术的75例患者进行回顾性分析，评估阴囊镜术后并发症、病变复发和附睾痛缓解情况，以病理检查结果为标准对比研究超声和阴囊镜诊断的准确率。结果：74例患者成功实施阴囊镜检，1例患者因鞘膜腔炎性粘连改开放手术，手术平均时间为（34.3±5.8） min，术后无严重阴囊水肿、血肿、睾丸鞘膜积液和伤口感染等并发症。阴囊镜和B超对睾丸扭转的诊断准确率分别为100%和66.7%，阴囊镜附睾肿块诊断与病理诊断符合率为76.2%，而B超与病理诊断符合率为58.7%。63例有症状附睾肿块患者接受阴囊镜附睾肿块等离子电切，患者术前阴囊疼痛视觉模拟评分为（7.1±0.8）分，术后6个月为（2.4±0.6）分。 结论：阴囊镜是安全的，阴囊镜对附睾肿块和睾丸扭转的诊断准确率高于B超检查，阴囊镜下等离子电切对附睾肿块（特别是附睾囊肿）引起的附睾疼痛治疗效果良好，术后肿块未见复发。

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.