Testicular skin pain

The scrotum is a very important organ in the male body, and the scrotum can contract and stretch according to the external temperature. If the scrotum is painful, we should pay attention to whether it is the pain in the scrotum epidermis or the pain inside. Pain in the epidermis may be caused by folliculitis, and the scrotum is inside the testicle. Orchitis may cause testicular pain, which needs our attention. So, what is the reason for the pain in the testicular epidermis?

(I) Acute non-specific orchitis: Acute non-specific orchitis often occurs in patients with urethritis, cystitis, prostatitis, prostatectomy and long-term indwelling catheters. The infection spreads to the epididymis through the lymph or vas deferens, causing epididymal orchitis. Common pathogens are Escherichia coli, Proteus, Staphylococcus aureus and Pseudomonas aeruginosa. Bacteria can spread to the testicles through the bloodstream, causing simple orchitis. However, the testicles have rich blood supply and strong resistance to infection, so this situation is relatively rare. Pathologically, the main macroscopic observation is enlarged, congested and tense testicles. Small abscesses are seen when the testicles are cut open. Histological examination showed focal necrosis, edema of connective tissue and infiltration of lobed granulocytes, inflammation, hemorrhage and necrosis of seminiferous tubules, and in severe cases, testicular abscess and testicular infarction.

(II) Chronic non-specific orchitis: Chronic orchitis is mostly caused by incomplete treatment of non-specific acute orchitis. It can also be caused by fungal, spirochetal, or parasitic infections, such as testicular syphilis. Patients with previous testicular trauma may develop granulomatous orchitis. Local or systemic radioactive isotope phosphorus irradiation of the testicles may also cause orchitis, destroying the testicular tissue. Pathologically, the testicles are enlarged or hardened and atrophied, the basement membrane of the seminiferous tubules is hyalinized and degenerative, and the spermatogenic epithelial cells disappear. There may be hardening around the seminiferous tubules, and small hyperplastic foci may also form.

(III) Acute mumps orchitis: Mumps is the most common cause of orchitis, and about 20% of mumps patients have orchitis. It is more common in late adolescence. The testicles are highly enlarged and purple-blue in color. When the testicles are cut open, the testicular tubules cannot be squeezed out due to the reaction and edema of the interstitial tissue. Histological observations show edema and vascular dilation, a large number of inflammatory cells infiltrate, and varying degrees of degeneration of the seminiferous tubules. When orchitis heals, the testicles become smaller and soft. The seminiferous tubules are severely atrophied, but the testicular interstitial cells are preserved, so the secretion of testosterone is not affected.