Which doctor is responsible for treating an abscess on the testicles?

An abscess on the testicles must be treated by a suitable specialist. Particularly in the case of severe swelling and/or pain, those affected must consult a doctor promptly. Under no circumstances should the abscess itself be squeezed out or punctured, as this can lead to serious complications.

A urologist is the right contact person for abscesses on the testicles. Diseases in the genital area and the urinary tract are part of the treatment spectrum of a urologist. However, a surgeon can also perform surgical removal of the abscess on the testicles.

The treatment is either carried out on an outpatient basis in the doctor’s practice or, in severe cases, in a hospital with inpatient admission of the patient. By means of an ultrasound examination the doctor can determine the spread and exact location of the abscess. The urologist then cuts open the abscess under local anaesthetic and allows the secretion to drain away.

Forecast

Both the course and prognosis of an abscess depend primarily on its size and localization. An abscess on the testicle is a special case. Due to the accumulation of pus inside the scrotum, appropriate treatment must be initiated immediately.

However, with prompt diagnosis and surgical opening of the abscess cavity, the prognosis is generally very good. During the operation, however, it must be ensured that the connective tissue capsule surrounding the abscess is completely removed. Otherwise it can be assumed that a new abscess will always form. Affected patients should also note that the fingers must never be used to press around the abscess.

What are the risks of a testicular abscess?

With an abscess there is always the danger that the abscess cavity opens inwards. In this way, the bacterial pathogens that persist inside the abscess cavity are released into the bloodstream. This can lead to blood poisoning (sepsis).

Sepsis is a potentially life-threatening disease that requires urgent treatment. In addition, the accumulation of pus inside the scrotum can cause important structures to be squeezed out. If the abscess causes a narrowing of the vessels supplying the testicle, this can lead to infertility.

Causes of an abscess on the testicles

There can be a variety of causes for the development of an abscess on the testicles. In most cases, the smallest injuries in the area of the skin surface, through which bacterial pathogens can enter the organism, are the cause. The bacterial pathogens responsible for the development of an abscess on the testes are mostly staphylococci (Staphylococcus aureus).

In many people these bacteria settle on the surface of the skin and mucous membranes as part of the normal flora. Especially the mucous membranes of the nasopharynx, the skin surface of the armpits and the female genital region are richly colonized with this bacterial pathogen. In males, Staphyloccocus aureus can be found mainly in the area of the perineum, i.e. between the anus and the testicles.

From there the bacterial pathogens can move to the scrotum. However, when the immune system is balanced, they do not cause any disease and are considered apathogenic pathogens. The reason for this is the fact that both the skin and the mucous membranes represent a natural barrier.

However, if the surface of the skin or mucous membrane is opened, the pathogens can penetrate the organism. In most people, even in this case an abscess does not develop, as the body’s own immune system can prevent infection. Especially people who have a weakened immune system tend to develop an abscess (for example on the testicles).

The bacterial pathogens that have entered the organism through the lesion of the scrotum are fought by white blood cells (leukocytes). In the course of this defensive reaction, purulent secretion can develop. This secretion usually consists of dead tissue remains, bacteria and white blood cells.

If the removal of the pus cannot be guaranteed, the organism begins to build a capsule of connective tissue fibres around the accumulation of pus. This is to prevent the pus-filled secretion from spreading further in the body. In addition, there are other factors that favour the development of an abscess on the testicles:

Diabetes mellitus
Chronic skin diseases (for example psoriasis or neurodermatitis)
Skin injuries (for example, through regular shaving of the genital region)

In men, abscesses often form on the perineum, the region between the scrotum and the anus.

The proximity to the anus favours the penetration of bacteria, especially Staphylococcus aureus, via hair shafts into the deep skin layers, where an inflammatory reaction with abscess formation then occurs. The inflammation can be felt as a firm lump and shows the typical symptoms of an abscess, which include pain, redness and swelling. The abscess can be very large and cause severe pain, which can also cause problems with defecation.

Early treatment of the abscess is important to prevent the spread of the inflammation and subsequent complications. Only rarely does the abscess between the testicles and the anus empty spontaneously and heal on its own. In most cases, however, the abscess must be surgically removed in the course of an operation.

The affected person receives a local anaesthetic or in severe cases an anaesthetic. The doctor cuts open the abscess and generously removes the surrounding dead tissue. Due to the proximity to the anal sphincter (Musculus sphincter ani), care must be taken, otherwise there is a risk that the patient will have to hold the stool after the operation.

The doctor then rinses the wound thoroughly with an antiseptic solution and places a drain through which the wound secretion can drain away. Usually the wound is not sutured in order to prevent another abscess cavity from encapsulating itself. An abscess can easily form between the testicles and the thigh, as friction often occurs at this point.

Tight-fitting garments, such as jeans or tight underpants, cause constant rubbing on the inside of the thigh, resulting in tiny injuries to the skin surface. If the skin is no longer intact, pathogens can easily penetrate the body and cause inflammation. As a result, in immunocompromised people, an encapsulated inflammation, i.e. an abscess, can form between the testicles and the thigh.

The abscess hurts and is sensitive to pressure and touch. The skin around the scrotum is also swollen and reddened. Small abscesses can be treated with pulling ointments if necessary, larger boils must be surgically removed by a doctor in any case. In any case it is advisable to consult a doctor to determine a suitable treatment.