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Benjamin, K.D. (2014). Conservative management of acute scrotal edema. Urologic Nursing, 34(3), 139-142. doi:10.7257/1053-816X.2014.34.3.139
Scrotal edema is a prevalent issue. It is difficult to treat and has a myriad of causes. Historical treatments for scrotal edema have lacked efficacy. If treated before fibrosis occurs, surgery can be avoided. A method for conservative management is outlined.
Key Words: Scrotal edema, fluid imbalance, lymphedema, scrotal sling, ascites, edema, anasarca.
Scrotal edema can be uncomfortable to the point of limiting mobility and activities of daily living. Though debilitating, it can be managed conservatively if treated before fibrotic tissue changes occur. Because it is a sensitive area and is located between the lower extremities, scrotal edema can be particularly painful and difficult to treat. Patients with scrotal edema are often reluctant to move, which results in even greater debility due to deconditioning. The longer the edema remains in the scrotum, the more likely fibrotic changes will occur that may require surgical intervention. Historically, treatment for scrotal edema is varied and does not often return the patient to his prior functional status. The method outlined reduces scrotal edema and is not as invasive or as costly as surgery. This article describes the reasoning behind a compressive scrotal support and a detachable neck strap.
Scrotum Structure and Function
The scrotum is a "dynamic" pouch made up of smooth muscle, connective tissue, and skin containing the testicles (Moore & Dalley, 2005). This anatomical design and elastic tissue composition is optimal for stretching and contracting to move the testicles closer to or further from the heat produced by the body to allow for maximal sperm production. The scrotum is a rounded bulbous pouch that narrows superiorly where it attaches to the central lower abdomen. This tapered anatomical neck helps prevent fluid from entering the scrotum from the abdomen but can make it difficult to expel the fluid once edema spreads to the scrotum. The scrotum is located anterior to the anatomical coronal midline of the body, which allows movement of the lower extremities.
There has been much debate about whether there is a fascial barrier between the scrotum, penis, and peritoneum (Martin, 1984). Recent evidence shows by computer-assisted tomography (CT) that no fascial barrier...