O 03. Experiences in treating idiopathic scrotal drooping

Objective: Scrotal drooping in adults is so rare that no previous cases have been reported. We describe our management of two patients with scrotal drooping.

Methods: Two patients visited our reproduction center for treatment of scrotal drooping. Case 1, who also had retrograde ejaculation for 2 years, complained about his scrotal drooping (length×width =15 cm × 7 cm) which was first noted approximately 5 years before presentation. Case 2 had a 23- year history of scrotal drooping (length×width =11 cm × 6 cm) accompanied by discomfort of which mainly described as a sense of heaviness. With the two patients squatting, their scrotums were both able to touch the floor. Blood serum testing, Doppler ultrasonography, and a detailed examination of the genitalia revealed no other abnormalities in either patient.

Results: Both patients underwent scrotoplasty and were satisfied with the cosmetic results and improvement in quality of life (QOL). Histologic evaluation showed slight thickening in the smooth muscle cells, with slightly disordered bundles in the dartos fascia of the scrotum in specimens from Case 1, and normal in that of Case 2. Case 1 whist received a microsurgical varicocelectomy and oral medication for the retrograde ejaculation and had no evidence of recurrence of scrotal drooping at a 7-year follow-up examination.

Conclusions: Scrotal drooping can cause considerable inconvenience and adverse emotional changes in patients. Our results indicate that scrotoplasty is effective, appropriate and necessary in improving patient QOL.