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Forum Name: Urology Topics

Question: Scrotal endoscopy-- is this possible?


 earthman74 - Thu Oct 29, 2009 10:28 pm

To understand why long-ago, one-side-only epididymectomy has been causing chronic pain (which is low level aching and a somewhat painful operated on testis and is not life disrupting pain for years and then, for some unknown reason, changes becoming constant, often ghastly physical pain for months-- anti-inflammatories can't be taken due to a stomach easily damaged by them), is it possible to do endoscopy to examine the inside of the half of the scrotum where the epididymectomy was done long ago? I hope a urologist can spot the problem area and then, if need be, cut open the scrotum to repair whatever is causing the dreadful, constant physical pain.

This same pain problem occurred in the past, post-epididymectomy, and then ended, restoring the half of the scrotum to the low-level pain and the somewhat painful testis.

A recent scrotal, color doppler ultrasound scan showed that blood flow to both testes is fine and OK. The scan also was negative for masses and tumors.

Aside from the ultrasound scan, what other kind of scan is useful to understand what might be wrong in the side of the scrotum where the epididymectomy was done?

[The surgeon who did the epididymectomy is long dead so another one will have to be consulted on this matter.]


Thanks
 earthman74 - Fri Oct 30, 2009 10:45 am

I forgot to mention that the painful area of the right side of the scrotum is easily identified: it's under the right flank of the right side of the scrotum quite close to the margin where the scrotal skin joins or merges with the groin/pelvis skin.

The pain goes through phases and is either of these two: 1) a constant, intense stinging-burning pain (which was common in the early weeks of this 2 month long bad pain spell which began on 26 August 09, and seems to be uncommon now), and 2) a constant, somewhat sickening-nauseating, deep, heavy aching which varies in intensity over the hours or days.

The simplest of body movements can make the pain suddenly worse, and ejaculation either makes the pain skyrocket instantly (less common) or causes the pain to increase within an hour after ejaculating and the pain then remains very high and constant for several days before moderating. At times it has felt as if something were being tugged or pulled internally by the right flank of the right side of the scrotum. This effect has been noted during some - but not all - sexual sessions.


Thanks
 Dr.M.Aroon kamath - Sat Oct 31, 2009 2:27 am

User avatar Hi,
Scrotal endoscopy (scrotoscopy) is definitely feasible.But the problem may be to find the person who is doing on a regular basis.

Advanced endoscopic systems are now available and they have made many organs accessible by endoscopy.

Whether endoscopy will be routinely used for accessing a certain organ or not depends on certain factors....
- ease with which the said organ can be accessed by 'open' surgery.
- length of the scar needed for the 'open' surgery.
- post-operative pain profile
- some other specific technical advantages.

For your problem, CT, MRI or a PET scan may be useful. Each has got its own advantages and disadvantages.
Best wishes!

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