Scrotal Hematoma: Causes, Symptoms, & Treatment

A scrotal hematoma, characterized by the extravasation of blood into the scrotal tissues, often presents following blunt trauma or surgical procedures such as a varicocelectomy. Pain, swelling, and discoloration are typical symptoms, necessitating prompt clinical evaluation that frequently involves imaging studies like ultrasound to determine the extent of the hematoma and rule out testicular rupture. Management strategies for a scrotal hematoma vary, ranging from conservative measures such as ice application and analgesics to surgical intervention by urologists in cases of significant size or persistent symptoms. The differential diagnosis includes other scrotal pathologies, making thorough assessment crucial to ensure appropriate care.

Image taken from the YouTube channel slangelier , from the video titled My experience (so far) with post vasectomy scrotal hematoma .

Scrotal hematomas represent a localized accumulation of blood within the scrotal sac. This condition, while often perceived as a minor inconvenience, can be indicative of underlying pathology and warrants careful evaluation. A scrotal hematoma is not simply a bruise; it is a sign of vascular disruption and extravasation of blood into the surrounding tissues.

The severity of a scrotal hematoma can vary significantly, ranging from small, self-limiting collections to large, potentially debilitating masses. Regardless of size, the presence of a hematoma necessitates prompt medical attention to ascertain the underlying cause and implement appropriate management strategies.

Discomfort and Underlying Etiologies

The primary concern associated with scrotal hematomas is the potential for significant discomfort. Patients often experience pain, swelling, and tenderness in the affected area. This discomfort can interfere with daily activities and impact quality of life.

However, the symptoms are secondary to the actual underlying cause. The causes are wide-ranging, including traumatic injuries, surgical complications (particularly following vasectomies), and bleeding disorders.

It is crucial to emphasize that scrotal hematomas, regardless of the apparent simplicity of the condition, should not be ignored. A comprehensive assessment is required to rule out more serious conditions, such as testicular rupture, torsion, or underlying vascular abnormalities.

Scope of Discussion

This editorial will delve into various aspects of scrotal hematomas, providing a comprehensive overview of the condition. We will explore the etiology and risk factors associated with their development, focusing on mechanisms of injury and predisposing conditions.

An understanding of scrotal anatomy is essential for comprehending the pathophysiology of hematoma formation; therefore, we will review the relevant anatomical structures and their functions. The clinical presentation of scrotal hematomas, including common signs and symptoms, will be discussed in detail to aid in prompt recognition and diagnosis.

The diagnostic approach to scrotal hematomas involves a combination of physical examination, imaging studies, and laboratory investigations. We will outline the diagnostic modalities used to differentiate scrotal hematomas from other scrotal pathologies.

Furthermore, we will explore the various management strategies for scrotal hematomas, ranging from conservative measures to interventional procedures. Finally, we will discuss the pharmacological considerations relevant to the management of scrotal hematomas, including pain control and the use of antibiotics.

Unveiling the Causes: Etiology and Risk Factors of Scrotal Hematomas

Scrotal hematomas represent a localized accumulation of blood within the scrotal sac. This condition, while often perceived as a minor inconvenience, can be indicative of underlying pathology and warrants careful evaluation. A scrotal hematoma is not simply a bruise; it is a sign of vascular disruption and extravasation of blood into the surrounding tissues. Understanding the various etiologies and risk factors is paramount for effective diagnosis and management.

Trauma: The Direct Impact

Trauma stands as a primary cause of scrotal hematomas. Both blunt and penetrating injuries can compromise the delicate vasculature within the scrotum, leading to blood accumulation.

Blunt trauma, such as a direct blow during a fall or assault, can rupture blood vessels without necessarily breaking the skin. Penetrating trauma, while less common, poses a more direct threat to vascular integrity.

It's crucial to ascertain the mechanism and severity of the injury to guide appropriate diagnostic and therapeutic interventions. The extent of the trauma often correlates with the size and severity of the hematoma.

Sports-Related Injuries: Elevated Risk in Athletes

Participation in contact sports significantly elevates the risk of scrotal hematomas. Activities like football, hockey, and martial arts expose athletes to a heightened likelihood of blunt trauma to the groin area.

The rapid movements, collisions, and potential for direct impact inherent in these sports can easily result in vascular damage. Protective gear, while helpful, does not entirely eliminate the risk.

Athletes experiencing scrotal pain or swelling should be promptly evaluated to rule out hematoma formation and other potential injuries.

Post-Surgical Complications: The Vasectomy Connection

Surgical procedures involving the scrotum, particularly vasectomies, carry an inherent risk of hematoma development. Vasectomies, while generally safe, involve manipulation of the vas deferens and surrounding blood vessels, potentially leading to bleeding.

Other scrotal surgeries, such as hydrocele or varicocele repairs, also pose a risk, albeit potentially less frequent than with vasectomies. Post-operative hematomas can cause pain, swelling, and prolonged recovery.

Careful surgical technique and meticulous hemostasis are essential to minimize this risk. Post-operative instructions typically include rest, ice application, and scrotal support to aid in healing and prevent complications.

Coagulation Disorders: Predisposition to Bleeding

Underlying coagulation disorders can significantly predispose individuals to scrotal hematomas, even in the absence of significant trauma. Conditions like hemophilia, von Willebrand disease, and thrombocytopenia impair the body's ability to form blood clots effectively.

Patients on anticoagulant medications, such as warfarin, heparin, or direct oral anticoagulants (DOACs), are also at increased risk due to the intentional thinning of the blood. Even minor trauma can result in a disproportionately large hematoma in these individuals.

A thorough medical history, including a review of medications and any known bleeding disorders, is crucial in evaluating scrotal hematomas.

Vascular Damage: The Source of the Bleeding

The development of a scrotal hematoma ultimately stems from damage to the scrotal or testicular blood vessels. This damage can manifest in various forms, ranging from small vessel rupture to complete vessel transection.

The scrotum's rich vascular supply makes it susceptible to bleeding even from seemingly minor injuries. The pampiniform plexus, a network of veins surrounding the spermatic cord, is particularly vulnerable.

Regardless of the underlying cause, identifying and addressing the source of bleeding is a crucial aspect of hematoma management. Early intervention to control bleeding can prevent further complications and promote faster healing.

Anatomy and Physiology: The Scrotum's Role

Scrotal hematomas represent a localized accumulation of blood within the scrotal sac. This condition, while often perceived as a minor inconvenience, can be indicative of underlying pathology and warrants careful evaluation. A scrotal hematoma is not simply a bruise; it is a sign that requires careful consideration of the anatomy and physiological processes at play within this critical region of the male reproductive system. A thorough understanding of these fundamentals is paramount in both diagnosis and treatment.

The Scrotum: More Than Just Skin

The scrotum, at its most basic, is a cutaneous sac. Its primary function is to house and protect the testicles.

But it is more complex than simple skin.

The scrotal skin is thin and rugated, allowing for temperature regulation.

This thermoregulatory role is vital for optimal spermatogenesis.

Testicular Function: Sperm Production and Hormonal Regulation

The testicles, suspended within the scrotum, serve dual roles. They produce sperm (spermatogenesis) and synthesize androgens, primarily testosterone.

Testosterone is critical for the development and maintenance of male secondary sexual characteristics, as well as influencing libido and bone density.

Any disruption to testicular function, whether from trauma or other pathology, can have significant implications for a man’s overall health and reproductive potential.

The Epididymis: Sperm Maturation and Storage

The epididymis, a tightly coiled tubular structure adjacent to the testicle, plays a crucial role in sperm maturation. As sperm cells transit through the epididymis, they undergo biochemical changes that render them capable of fertilization.

The epididymis also serves as a storage reservoir for mature sperm. Injury to the epididymis can disrupt this process, potentially impacting fertility.

The Spermatic Cord: A Vulnerable Conduit

The spermatic cord is a complex structure that suspends the testicle within the scrotum. It contains the vas deferens, testicular artery, pampiniform plexus of veins, and nerves.

The cord's contents are particularly vulnerable to injury. Trauma to the spermatic cord can result in bleeding and hematoma formation, as well as potential damage to the vas deferens, compromising fertility.

The pampiniform plexus, responsible for cooling arterial blood before it enters the testicle, is also susceptible to injury, potentially affecting testicular temperature regulation.

Coagulation and Hemostasis: The Body's Defense Against Bleeding

Coagulation and hemostasis are complex physiological processes that prevent excessive bleeding following injury.

Coagulation involves a cascade of enzymatic reactions that lead to the formation of a fibrin clot, effectively sealing damaged blood vessels.

Hemostasis encompasses all the processes involved in stopping bleeding, including vasoconstriction, platelet plug formation, and coagulation.

Disruptions to the coagulation cascade, whether due to inherited disorders or medications like anticoagulants, can predispose individuals to hematoma formation, even with minor trauma. Understanding these processes is critical in managing patients with scrotal hematomas, particularly those on anticoagulant therapy.

Identifying the Problem: Signs and Symptoms of Scrotal Hematomas

Scrotal hematomas represent a localized accumulation of blood within the scrotal sac. This condition, while often perceived as a minor inconvenience, can be indicative of underlying pathology and warrants careful evaluation. A scrotal hematoma is not simply a bruise; it is a sign that requires careful consideration and, often, medical attention. Recognizing the specific signs and symptoms is crucial for early detection and appropriate management.

Scrotal Pain: A Primary Indicator

Pain is frequently the initial and most prominent symptom associated with a scrotal hematoma. The intensity of the pain can vary significantly, ranging from a mild ache to severe, debilitating discomfort. The character of the pain may also differ, described as sharp, throbbing, or a constant, dull ache.

The sudden onset of pain, especially following trauma, should raise suspicion for a hematoma or other testicular injury. It is imperative to note the onset, duration, and characteristics of the pain, as this information assists in differential diagnosis and treatment planning.

Scrotal Swelling: A Key Objective Sign

Scrotal swelling is a palpable and visible sign of a hematoma. The accumulation of blood within the scrotal tissues leads to an enlargement of the scrotum, which can be readily observed upon physical examination. The degree of swelling often correlates with the size of the hematoma and the extent of bleeding.

In some cases, the swelling may be subtle and difficult to detect, particularly with small hematomas. However, in more significant cases, the swelling can be quite pronounced, causing considerable distortion of the scrotum.

Scrotal Bruising: Discoloration and Extravasated Blood

Bruising, or ecchymosis, is another hallmark sign of a scrotal hematoma. The discoloration results from the extravasation of blood into the subcutaneous tissues. The color of the bruising typically changes over time, transitioning from a reddish-blue to a greenish-yellow as the blood is gradually reabsorbed by the body.

The extent and location of the bruising can provide clues about the source and severity of the bleeding. Widespread bruising may indicate more extensive tissue damage. The absence of visible bruising, however, does not necessarily rule out the presence of a hematoma, especially in deeper tissue injuries.

Tenderness Upon Palpation: Sensitivity to Touch

Tenderness to touch is a common finding in individuals with scrotal hematomas. Palpation of the affected area elicits pain or discomfort, indicating underlying inflammation and tissue damage. The degree of tenderness can vary depending on the size and location of the hematoma, as well as the individual's pain tolerance.

Gentle palpation is essential to assess the extent of tenderness and to identify any underlying masses or abnormalities. Excessive pressure should be avoided to prevent further discomfort. The presence of significant tenderness can help differentiate a hematoma from other scrotal conditions that may present with swelling but without pain.

The Diagnostic Journey: How Scrotal Hematomas are Evaluated

Scrotal hematomas, while often visibly apparent, require a systematic diagnostic approach to ascertain the underlying cause, rule out other potentially serious conditions, and guide appropriate management. This process involves the collaborative efforts of various medical professionals, a detailed physical examination, judicious use of imaging modalities, and, in some cases, laboratory studies.

The Multidisciplinary Team

The diagnosis and management of scrotal hematomas often involve a team of healthcare professionals, each playing a vital role in ensuring optimal patient care.

• Urologists are central to the process, providing expertise in diagnosing and treating conditions of the male reproductive system, including scrotal hematomas. Their involvement is crucial for definitive diagnosis and management planning.

• Emergency Room Physicians are frequently the first point of contact for patients experiencing acute scrotal pain or trauma. Their initial assessment is critical for triaging patients and initiating the diagnostic workup.

• General Practitioners and Family Physicians may be the first to evaluate patients with less acute symptoms. They play a vital role in initial assessment, referral to specialists, and ongoing care.

• Radiologists are essential for interpreting imaging studies, such as ultrasounds and CT scans, providing critical information about the size, location, and characteristics of the hematoma, as well as ruling out other potential pathologies.

• Nurse Practitioners and Physician Assistants often contribute to patient evaluation, education, and follow-up care, working under the supervision of physicians.

The Importance of Physical Examination

A thorough physical examination is paramount in the evaluation of scrotal hematomas. The examination should include:

• Visual Inspection: Assessing the scrotum for signs of swelling, bruising, and skin changes.

• Palpation: Carefully palpating the scrotum to identify areas of tenderness, masses, or irregularities.

• Assessment of the Testicles and Epididymis: Evaluating the size, shape, and consistency of the testicles and epididymis to rule out other conditions, such as testicular torsion or epididymitis.

• Inguinal Lymph Node Examination: Checking for enlarged lymph nodes, which may indicate infection or inflammation.

Imaging Modalities

Imaging plays a crucial role in confirming the diagnosis of scrotal hematoma, assessing its extent, and ruling out other conditions.

• Ultrasound is generally the primary imaging modality used to evaluate scrotal hematomas. It is non-invasive, readily available, and provides excellent visualization of the scrotal contents.

• Doppler Ultrasound assesses blood flow to the testicles, helping to rule out testicular torsion or other vascular abnormalities. It is an essential tool in differentiating hematomas from more emergent conditions.

• CT Scans are typically reserved for cases involving significant trauma, where there may be concern for other injuries. CT scans can provide detailed images of the scrotum and surrounding structures, helping to identify fractures, dislocations, or other complications.

Laboratory Studies

Laboratory studies are not always necessary for the diagnosis of scrotal hematomas. However, they may be indicated in certain situations.

• Blood Tests, including coagulation studies, may be performed to evaluate for underlying bleeding disorders, especially in patients with a history of easy bruising or bleeding.

• Complete Blood Count (CBC) may be ordered to assess for signs of infection or other blood abnormalities. This helps in identifying associated problems that may be worsening or even causing the issue.

The diagnostic journey for a scrotal hematoma is multifaceted. It involves expert examination, judicious use of imaging, and often, assessment in a team. This rigorous approach ensures that the issue is correctly identified and managed for the best patient outcome.

Ruling Out Other Conditions: Differential Diagnosis

Scrotal hematomas, while often visibly apparent, require a systematic diagnostic approach to ascertain the underlying cause, rule out other potentially serious conditions, and guide appropriate management. This process involves the collaborative efforts of various medical professionals, a thorough clinical evaluation, and judicious use of imaging and laboratory studies.

One of the most critical aspects of evaluating a patient with a suspected scrotal hematoma is differentiating it from other conditions that can present with similar signs and symptoms. A missed or delayed diagnosis of certain conditions can have devastating consequences.

The Urgency of Excluding Testicular Torsion

Testicular torsion stands paramount among the differential diagnoses for scrotal hematomas, demanding immediate consideration. This is due to its potential for irreversible testicular damage within a matter of hours.

Testicular torsion occurs when the spermatic cord, which suspends the testicle within the scrotum, twists. This twisting compromises blood flow to the testicle.

Prolonged ischemia can lead to testicular infarction and subsequent loss of the affected testicle. Therefore, a rapid and accurate diagnosis is paramount.

Overlapping Symptoms and Distinguishing Features

Both scrotal hematomas and testicular torsion can manifest with acute scrotal pain, swelling, and tenderness. However, certain clinical features can help differentiate between the two:

• Onset of Pain: Testicular torsion typically presents with a sudden, severe onset of pain. Scrotal hematomas, depending on the etiology, may have a more gradual onset.

• Nausea and Vomiting: These symptoms are more commonly associated with testicular torsion due to the intense pain and autonomic nervous system response.

• Testicular Position: On physical examination, the affected testicle in torsion may be elevated or lie in a horizontal position, often described as a "bell clapper" deformity.

• Cremasteric Reflex: This reflex, elicited by stroking the inner thigh and observing elevation of the testicle, is often absent in testicular torsion.

• Prehn's Sign: Elevation of the scrotum may relieve pain in epididymitis but typically does not alleviate pain in testicular torsion. However, relying solely on Prehn's sign can be misleading.

Imaging Modalities in Differential Diagnosis

Doppler ultrasound is the primary imaging modality used to evaluate acute scrotal pain. In testicular torsion, Doppler ultrasound may demonstrate absent or significantly reduced blood flow to the affected testicle.

Conversely, a scrotal hematoma may show normal or increased blood flow around the hematoma. However, it's essential to recognize that intermittent torsion or spontaneous detorsion can complicate the interpretation of Doppler findings.

Other Conditions to Consider

While testicular torsion is the most pressing concern, other conditions must also be considered in the differential diagnosis of scrotal hematomas:

• Epididymitis/Orchitis: These inflammatory conditions can cause scrotal pain and swelling. However, they are typically associated with gradual onset, fever, and dysuria. Urinalysis may reveal pyuria or bacteriuria.

• Hydrocele/Varicocele: These conditions, involving fluid accumulation or dilated veins within the scrotum, are typically painless or cause a dull ache, rather than acute pain.

• Hernia: Inguinal hernias can sometimes extend into the scrotum, causing swelling and discomfort.

• Testicular Tumor: While often painless initially, testicular tumors can occasionally present with acute pain due to hemorrhage or infarction.

Clinical Judgement and Prompt Action

Ultimately, the diagnosis of scrotal hematoma and exclusion of other conditions, especially testicular torsion, rely on a combination of thorough history taking, careful physical examination, and appropriate use of imaging studies.

In cases where testicular torsion cannot be definitively ruled out based on clinical and imaging findings, prompt surgical exploration is warranted to avoid potential testicular loss. Clinical suspicion should trump imaging results when the risk of torsion is high.

Early consultation with a urologist is critical in any patient presenting with acute scrotal pain. This ensures timely and appropriate management, mitigating the risk of long-term complications.

Treatment Options: Managing Scrotal Hematomas

Scrotal hematomas, while often visibly apparent, require a systematic diagnostic approach to ascertain the underlying cause, rule out other potentially serious conditions, and guide appropriate management. This process involves the collaborative efforts of various medical professionals, a thorough clinical evaluation, and judicious use of imaging techniques. Once a scrotal hematoma is diagnosed, the treatment strategy pivots based on the size, location, symptoms, and underlying etiology of the hematoma.

Conservative Management: A Watchful Waiting Approach

In many cases, conservative management forms the cornerstone of treatment for small to moderate-sized scrotal hematomas, particularly when the patient is hemodynamically stable and there's no evidence of significant underlying injury or infection. This approach prioritizes symptom relief and allows the body's natural healing mechanisms to resolve the hematoma over time.

The RICE Protocol and Supportive Measures

The initial steps in conservative management often involve the implementation of the RICE protocol—Rest, Ice, Compression, and Elevation—along with the use of supportive measures.

• Ice Packs: Applying ice packs to the scrotum for 15-20 minutes at a time, several times a day, helps to reduce swelling and alleviate pain through vasoconstriction and decreased inflammatory response.

• Elevation: Elevating the scrotum, often achieved by lying down with a pillow placed underneath, promotes venous drainage and minimizes edema formation.

• Pain Management: Over-the-counter analgesics such as acetaminophen or ibuprofen can effectively manage pain. In cases of severe pain, stronger prescription analgesics may be considered, but opioid use should be minimized due to the risk of dependence and other adverse effects.

• Rest and Activity Modification: Limiting physical activity and avoiding strenuous activities that could exacerbate the hematoma or increase scrotal trauma is crucial for promoting healing.

• Supportive Underwear: Wearing supportive underwear or a jockstrap provides comfort and support to the scrotum, reducing strain and promoting optimal healing conditions.

Observation and Monitoring

Close observation is vital to ensure that the hematoma resolves as expected and that no complications arise. This includes monitoring for signs of infection (fever, increased pain, redness), increasing size of the hematoma, or any new or worsening symptoms. Follow-up appointments with a healthcare provider are essential to track progress and adjust the treatment plan as needed.

Interventional Procedures: When More Aggressive Action is Required

In cases where conservative management fails to provide adequate relief, or when complications arise, interventional procedures may be necessary to address the scrotal hematoma effectively.

Needle Aspiration: A Minimally Invasive Option

Needle aspiration involves the percutaneous insertion of a needle into the hematoma to aspirate the accumulated blood. This procedure may be considered for larger, symptomatic hematomas that are not resolving with conservative measures. Ultrasound guidance is often used to ensure accurate needle placement and minimize the risk of injury to surrounding structures. While needle aspiration can provide immediate relief by reducing pressure and swelling, there is a risk of re-accumulation of the hematoma, infection, or bleeding.

Surgical Drainage: Evacuating Persistent Hematomas

Surgical drainage is a more invasive procedure that involves making an incision in the scrotum to directly evacuate the hematoma. This approach is typically reserved for large, organized hematomas that are not amenable to needle aspiration, or when there is evidence of infection or underlying tissue damage. The procedure is performed under sterile conditions, and a drain may be placed to prevent re-accumulation of fluid. Surgical drainage allows for thorough evacuation of the hematoma and facilitates the removal of any necrotic tissue or debris.

Surgical Exploration: Addressing Underlying Injuries

In cases of significant scrotal trauma, surgical exploration may be necessary to assess and repair any underlying injuries to the testicles, epididymis, or spermatic cord. This procedure involves making an incision in the scrotum to directly visualize the scrotal contents and identify any vascular injuries, testicular rupture, or other structural abnormalities. Surgical exploration allows for definitive repair of the underlying injuries, preventing long-term complications and preserving testicular function.

Medication Considerations: Pharmacological Aspects of Scrotal Hematomas

Scrotal hematomas, while often visibly apparent, require a systematic diagnostic approach to ascertain the underlying cause, rule out other potentially serious conditions, and guide appropriate management. This process involves the collaborative efforts of various medical professionals, a thorough clinical evaluation, and judicious use of imaging modalities. Pharmacological interventions play a crucial, yet nuanced, role in the overall management strategy. Medications can address pain, mitigate risks associated with pre-existing conditions or treatments, and combat potential infections.

Analgesic Management

Pain is a common and often significant symptom associated with scrotal hematomas. Effective pain management is crucial for patient comfort and facilitating healing. Analgesics, or pain relievers, are a mainstay of symptomatic treatment.

Over-the-Counter Options

For mild to moderate pain, over-the-counter (OTC) analgesics like acetaminophen (paracetamol) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen are often sufficient. Acetaminophen primarily targets pain, while NSAIDs also reduce inflammation, which can contribute to pain and swelling. However, NSAIDs should be used with caution, especially in individuals with underlying bleeding disorders or those taking anticoagulants, as they can further inhibit platelet function and potentially exacerbate bleeding.

Prescription Analgesics

In cases of severe pain, stronger prescription analgesics may be necessary. Opioid analgesics, such as codeine, oxycodone, or hydrocodone, can provide significant pain relief but carry a risk of dependence and side effects like constipation and drowsiness. Due to these risks, opioids should be prescribed judiciously, at the lowest effective dose, and for the shortest duration possible. Non-opioid alternatives, like tramadol, may also be considered, although they also have potential side effects and risks.

Anticoagulation Considerations

Patients on anticoagulant medications pose a unique challenge when they develop a scrotal hematoma. Anticoagulants, such as warfarin, heparin, and direct oral anticoagulants (DOACs) like rivaroxaban and apixaban, are prescribed to prevent blood clots in individuals at risk of thromboembolic events. However, these medications increase the risk of bleeding, including hematoma formation.

Balancing Risks

Managing a scrotal hematoma in a patient on anticoagulants requires careful consideration of the risks and benefits of continuing, reducing, or temporarily discontinuing the medication. This decision should be made in consultation with the prescribing physician, considering the indication for anticoagulation and the severity of the hematoma. In some cases, the anticoagulant may need to be temporarily held or the dose reduced until the hematoma resolves. Reversal agents, such as vitamin K for warfarin or specific antidotes for DOACs, may be considered in severe cases, but their use must be carefully weighed against the risk of thromboembolic complications.

Monitoring and Management

Close monitoring of coagulation parameters, such as INR for warfarin or anti-Xa levels for DOACs, is essential. Local measures, such as ice packs and scrotal support, are particularly important in patients on anticoagulants to minimize bleeding and promote healing.

Antibiotic Use

While scrotal hematomas themselves are not typically caused by infection, the disrupted tissue and presence of blood can create a favorable environment for bacterial growth. Antibiotics are generally not indicated for uncomplicated scrotal hematomas.

Prophylactic Use

Prophylactic antibiotics may be considered in specific situations, such as in patients undergoing surgical drainage of a large hematoma or those at high risk of infection (e.g., immunocompromised individuals). The choice of antibiotic should be guided by local resistance patterns and the potential source of infection.

Treating Infection

If signs of infection develop, such as fever, redness, warmth, or purulent drainage, prompt antibiotic treatment is essential. Cultures of any drained fluid should be obtained to identify the causative organism and guide antibiotic selection. Broad-spectrum antibiotics may be initiated empirically, followed by targeted therapy based on culture results.

Video: Scrotal Hematoma: Causes, Symptoms, & Treatment

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So, if you're experiencing any of the symptoms we've discussed, don't hesitate to see a doctor. Scrotal hematoma, while often benign, is definitely something you want to get checked out to rule out anything serious and get you back to feeling like yourself again.