Testicular relocation

Case contributed by Ashesh Ishwarlal Ranchod
Diagnosis certain

Presentation

Bilateral inguinal and medial thigh pain. Previous Fournier's gangrene and surgical management.

Patient Data

Age: 60 years
Gender: Male
ultrasound

The patient has an empty, collapsed and debrided scrotal sac.

Bilaterally the testes are relocated into anteromedial thigh pouches. Bilaterally the testes remain viable with normal Doppler flow. There is no torsion and no focal testicular abnormality. The associated epididymal heads also appear normal. Dual left paratesticular cysts identified on the left, of uncertain etiology or significance.

Incidental, benign, reactive inguinal lymph nodes identified bilaterally. There were no direct or indirect inguinal hernias to account for the pain.

Sonographer: Ms Bibi Ayesha Motala

Case Discussion

This diabetic patient had a history of severe Fournier's gangrene approximately 2 years back. Due to the extensive scrotal skin loss and significant debridement, the testes and epididymides were surgically relocated into anteromedial thigh pouches. This is usually a temporary surgical option to allow for scrotal wound healing and delayed closure. Occasionally permanent anteromedial thigh pouches are made and the testes are relocated permanently. In this instance, the patient presented with a history of 2 years and it is uncertain if reconstruction and testicular relocation into the scrotum will still be possible.

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