Advertisement

Inguino-Scrotal Surgery

  • O. Kalejaiye
  • Amr Abdel Raheem
  • D. Ralph
Chapter

Abstract

In this chapter we will be discussing several benign conditions affecting the groin and scrotum which andrologist may be involved in managing. Knowledge of the anatomy of this area and potential complications is very important. The rich vascular supply to the scrotum means that any surgical procedure must involve meticulous haemostasis. The scrotum obtains its blood supply from two different directions: transversely and longitudinally. This means that the scrotal wall is usually a very forgiving structure with good healing following both trauma and surgery. The midline raphe incision is utilised in most procedures as it is associated with the best cosmesis. In surgery on or near the epididymis it’s important to be aware of the location of the rete testis with its terminal blood supply to the testis. The rete testis is also the only connection between the testis and the epididymis. This means that epididymal surgery may result in compromise of the blood supply to the testis and epididymis as well as cause epididymal obstruction.

References

  1. 1.
    Inci K, Gunay L. The role of varicocele treatment in the management of non-obstructive azoospermia. Clinics. 2013;68(S1):89–98.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Chiba K, Fujisawa M. Clinical outcomes of varicocele repair in infertile men: a review. World J Mens health. 2016;34(2):101–9.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Muneer A, Arya M, Jordan G. Atlas of male genitourethral surgery. Hoboken, NJ: Wiley; 2013.Google Scholar
  4. 4.
    Hancocok P, Woodward B, Muneer A, et al. 2016 Laboratory guidelines for postvasectomy semen analysis: association of biomedical andrologists, the British Andrology society and the British Association of urological surgeons. J Clin Pathol. 2016;69(7):655–60.  https://doi.org/10.1136/jclinpath-2016-203731.CrossRefGoogle Scholar
  5. 5.
  6. 6.
    Rioja J, Sànchez-Margallo F, Usón J, et al. Adult hydrocele and spermatocele. BJU Int. 2011;107:1852–64.CrossRefPubMedGoogle Scholar
  7. 7.
    West A, Leung H, Powell P. Epidiymectomy is an effective treatment for scrotal pain after vasectomy. BJU Int. 2000;85:1097–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Nariculam J, Minhas S, Adeniyi A, et al. A review of the efficacy of surgical treatment for and pathological changes with chronic scrotal pain. BJU Int. 2007;99:1091–3.CrossRefPubMedGoogle Scholar
  9. 9.
    Benson J, Abern M, Larsen S, et al. Does a positive response to spermatic cord block predict response to microdenervation of the spermatic cord for chronic scrotal pain? J Sex Med. 2013;10:876–82.CrossRefPubMedGoogle Scholar
  10. 10.
    Levine L. Chronic orchialgia: evaluation and discussion of treatment options. Ther Adv Urol. 2010;5(5–6):209–14.CrossRefGoogle Scholar
  11. 11.
    Larsen S, Benson JS, Levine LA. Microdenervation of the spermatic cord for chronic scrotal content pain: single institution review analyzing success rate after prior attempts at surgical correction. J Urol. 2013;189(2):554–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Levine L. Microsurgical denervation of the spermatic cord. J Sex Med. 2008;5:526–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • O. Kalejaiye
    • 1
    • 2
  • Amr Abdel Raheem
    • 2
    • 3
  • D. Ralph
    • 2
  1. 1.Department of AndrologyUniversity College LondonLondonUK
  2. 2.Department of UrologyUniversity College HospitalsLondonUK
  3. 3.Department of AndrologyCairo UniversityCairoEgypt

Personalised recommendations