Management of Chronic Scrotal Swelling at the Urology Department of de la Paix Hospital of Ziguinchor

Aboubacar Traore; Modou Ndiaye; Mohamed Doukoure; Awa Ciss Sonko; Modou Diop Ndiaye; Boubacar Fall

doi:doi:10.11648/j.ijcu.20250902.29

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Management of Chronic Scrotal Swelling at the Urology Department of de la Paix Hospital of Ziguinchor

Aboubacar Traore^*

, Modou Ndiaye

, Mohamed Doukoure

, Awa Ciss Sonko, Modou Diop Ndiaye, Boubacar Fall

Published in International Journal of Clinical Urology (Volume 9, Issue 2)

Received: 26 November 2025 Accepted: 15 December 2025 Published: 26 December 2025

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Abstract

Introduction: Chronic scrotal swelling is a common reason for consultation at Urology. Its global prevalence remains unknown. Among adults, it is often perceived as a shameful condition. Traditional treatments expose patients to potentially severe complications. This study aimed to assess the management of chronic scrotal swelling within our department. Methods: We conducted a four-year retrospective descriptive study (January 1, 2017–December 31, 2020). All patients who underwent surgery for chronic scrotal swelling at the Urology Department of De la Paix Hospital of Ziguinchor, were included. Data were collected from medical records. Variables studied included epidemiological, clinical, etiological, therapeutic, and evolutionary parameters. Results: A total of 67 patients were recorded (frequency: 23.3%). The mean age was 54.3 years for adults (range: 20–89 years) and 4.8 years for children (range: 7 months–12 years). Farmers were the most represented group (34.5%). A history of inguinal hernia repair was noted in 12.1%. Scrotal swelling was the main reason for consultation (83%). The right side was affected in 43%. The mean duration of symptoms was 5 years. Inguino-scrotal hernia was the most common etiology (53.4%), while a persistent peritoneo-vaginal duct (PPVD) was the sole cause in children. Bassini technique was used in 27.6% of cases of hernia. In-hospital follow up was performed for 24 hours in 63.8% of adults and 77.7% of children. At 3-month follow-up, outcomes were unremarkable in 96.5%. Complications occurred only on adults including operative wound infection, chronic pain with testicular hypotrophy, and one death. Conclusion: Chronic scrotal swelling can occur at any age and remains a frequent condition in urology. Diagnosis is primarily clinical, and surgery is essential but can lead to potential complications.

Published in	International Journal of Clinical Urology (Volume 9, Issue 2)
DOI	10.11648/j.ijcu.20250902.29
Page(s)	214-218
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Chronic Scrotal Swelling, Surgery, Scrotal Hernia, Hydrocele

1. Introduction

Chronic large scrotum is a frequent reason for consultation in urology. Its exact global prevalence is unknown. Cultural decency and the absence of life-threatening prognosis often contribute to chronicity

[1]

. Management poses diagnostic and therapeutic challenges, and traditional treatments (such as fumigation) may lead to severe complications, including gangrene

[2]

. This study aimed to evaluate the management of chronic large scrotums in the Urology Department of De la Paix Hospital of Ziguinchor.

2. Patients and Methods

We conducted a retrospective and descriptive study over a four-year period (January 1, 2017, to December 31, 2020). It included all patients who underwent surgery for chronic large scrotum (congenital or acquired) in the urology department of the Hôpital de la Paix in Ziguinchor. Data was collected from patient records.

The variables studied were:

Epidemiological: frequency, age, and occupation;

Clinical: medical and surgical history, reasons for consultation, progression, clinical signs, and morphological examinations.

Etiological: etiological factors.

Therapeutic and evolving: type of surgical procedure, type of anesthesia, postoperative outcomes, length of hospital stay, postoperative complications.

3. Results

We recorded 67 patients who underwent surgery for chronic large bursitis, of whom 86.6% (n: 58) were adults and 13.4% (n: 9) were children. The frequency was 23.3% among the urological conditions monitored in the department. The average age of adults was 54.3 ± 17.7 years [20 and 89 years] (Table 1), compared to 4.8 ± 4.3 years [7 months and 12 years] in children. The majority of our patients were farmers (34.5% [n: 20]), and a history of inguinal hernia repair was reported in 12.1% (n: 7) (Table 1). One case of prematurity at 34 weeks was reported.

Table 1. Distribution of Sociodemographic Data Among Adults.

Sociodémographic. Data	Effective	Percentage (%)
Age range
[20-40]	8	16,6
[40-60]	15	31,3
≥ 60	25	52,1
Occupation
Farmers	20	34,5
Traders	7	12,1
Laborers	6	10,3
Teachers	5	8,6
Pupils/Students	3	5,2
Medical History
Inguinal hernia Repair	7	12,1
Pulmonary Tuberculosis	3	5,2
Scrotol Trauma	1	1,7
Varicocele Repair	1	1,7

Scrotal swelling was the main reason for consultation (83%). In adults, the right side was most commonly affected (43%) (Figure 1), while children more frequently presented left-sided pattern (66.7%). Among children, chronic scrotal swelling was associated with umbilical hernia in 22.2%. Average symptom duration was 5 years (4 months–20 years). Use of traditional remedies (steam or herbal infusions) was noted in 20.7%. Prostate tumors were associated in 19% of adult cases.

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Figure 1. Distribution According to the Grade Achieved in Adults.

Scrotal ultrasound was performed in 43.1% of patients and helped identify the etiology. The most frequent diagnoses were simple inguino-scrotal hernia 53.4% (n: 31),, followed by hydrocele 32.7% (n: 19); PPVD was the exclusive cause among children (Table 2).

Table 2. Distribution According to Etiological Diagnosis and Surgical Procedures.

Etiological diagnoses and surgical procedures	Number	Percentage (%)
Etiological diagnoses
Inguino scrotal hernia	31	53,4
Vaginal Hydrocele	19	32,7
PPVD	9	15,5
Cord Cyst	7	12,1
Grade 3 Varicocele	1	1,7
Testiclar Tumor	1	1,7
Procedure
Hydrocele Repair	19	32,7
Bassini Repair	16	27,6
Prosthetic Hernia Repair	15	25,8
PPDV Repair	9	15,5
Cystectomy	7	12,1
Bilaterale Orchidectomy	1	1,7
Varicocele Repair	1	1,7

Spinal anesthesia was used in 94.8% of adults, whereas general anesthesia with orotracheal intubation was performed in 55.6% of children. Procedures included hydrocele repair using the Bergmann technique 32.7% (n=19), Bassini hernia repair 27.6% (n=16), and ligation-section of the PPVD in all children (Table 2).

A 24-hour observation period was routine for 63.8% of adults, with an average hospital stay of 2 days [1 to 8 days]. The 24-hour observation period was 77.7% for children. In adults, immediate postoperative outcomes were uncomplicated in 98.3% of cases and remained favorable after 3 months in 96.5% (n: 55); however, one case of wound infection and chronic inguinal pain associated with testicular hypotrophy was observed. A 78-year-old patient with heart disease who was being monitored died at home from unknown causes on day 23 of treatment for a hernia associated with a prostate adenomectomy. After a 3-month follow-up, no complications were noted in children.

4. Discussion

In our study, chronic large swelling was the most common urological pathology. This frequency may be underestimated, as many patients delay consultation due to decency. Adults and infants were in the majority in our series. In the study of M Kafka and al, on hydrocele, the average age of patients was 43 years

[3]

. In the pediatric series by G Ngom and al, the age group from 29 days to 30 months was the most represented

[4]

. Medical and surgical histories were noted in our patients (hernia repair, prematurity, etc.). Recurrence is a complication of hernia repair and can also lead to certain types of large scrotums (hydrocele)

[5]

The most common reason for consultation in adults was scrotal or inguinal-scrotal swelling. M Kafka and al, reported a painful episode in 17.9% of cases

[3]

. Scrotal swelling generally only prompt consultation in cases of significant functional discomfort (difficulty with sexual intercourse or urination) or infertility in the couple. In children, congenital scrotal swelling was the reason for consultation. A Sarr and al, in their study on PCPV pathologies, reported 72.3% inguinal swelling and 27.7% inguinal-scrotal swelling, In our series, the right side was most often affected in adults

[6]

. MN Guena and al, found equal involvement of both sides 42.5%

[7]

. Left-sided involvement was common in children. Right-sided involvement was predominant in children in the series by M Ndiaye and al; and G Ngom and al, in 56% and 63.2% of cases, respectively

[4, 8]

In our series, the etiologies of chronic scrotal swelling in adults were dominated by inguinal-scrotal hernia (ISH). K Ouattara and al, found ISH to be the primary etiology in 20.9% of cases

[9]

. These are most often pathologies affecting the elderly

[10]

. The large number of farmers and prostate tumors were also risk factors observed in our patients. Vaginal hydrocele came in second place. It is the third leading cause of scrotal swelling in Africa, accounting for 17.8% of cases

[11]

. Studies conducted in Senegal and Congo reported frequencies of 10% and 4.4%, respectively

[10, 12]

. These data reflect the quasi-endemic nature of the disease in tropical countries. PPDV was the etiology in all children in our series. This can be explained by the high frequency of this congenital pathology, which has been widely reported in previous studies

[4, 8]

Surgical management was performed in all patients. A recent systematic review on the management of inguinoscrotal hernias recommends the adoption of a new classification for comparing indications based on size and stipulates an approach based on available local resources and the surgeon's skills

[13]

. The average hospital stay for our patients was 2 days, and the postoperative course was marked by some complications (hemorrhage from the surgical site, wound suppuration), which were controlled by antibiotic therapy and local care. In a systematic review of hydrocele treatment, postoperative complications, costs, and recovery time were lower in the aspiration-sclerotherapy group; however, the recurrence rate was higher. Short-term healing was no different between surgery and sclerotherapy, with heterogeneity in the data

[14]

. M Coulibaly and al, also reported wound infection as a postoperative complication

[2]

. M Kafka and al, described per- or postoperative complications in 5 out of 156 patients

[3]

. In a series of over 1,775 Lichtenstein procedures for ISH, early postoperative complications were 5.3% and mortality was zero; chronic pain was noted at rest (2.2%) and during exertion (4.4%)

[15]

. These complications could be related to surgery or poor local care, sometimes prolonging the stay and increasing the cost of care.

5. Conclusion

Chronic scrotal swelling can occur at any age and may be congenital or acquired. It is a frequent urological condition. In adults, embarrassment often leads to delayed consultation. Diagnosis is mainly clinical, and surgery remains the cornerstone of management, though it carries a risk of complications.

Abbreviations

ISH	Inguinoscrotal Hernia
PPVD	Persistent Peritoneo-vaginal Duct

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	EV Sewa. Hydrocele: treating this testicular condition. Afr J Urol 2016; 9. https://doi.org/10.1016/j.afju.2016.04.001
[2]	M Coulibaly, LT Coulibaly, S Guisse, HJG Berthe, ML Diakite, Z Ouattara. Management of Bursa Pathologies at Gabriel Toure University Hospital. Health Sci Dis 2019; 20: 50–4. https://doi.org/10.5281/hsd.v20i5.1422
[3]	M Kafka, K Strohhacker, F Aigner, F Steinkohl, W Horninger, R Pichler, and al. Incidental TesticularPathologies in Patients With Idiopathic Hydrocele Testis: Is Preoperative Scrotal Ultrasound Justified? Anticancer Res 2020; 40: 2861–4. https://doi.org/10.21873/anticanres.14261
[4]	Ngom G, Mohamed A, Saleck A, Mbaye P, Ndour O, Faye A, et al. Uncomplicated processus vaginalis in Dakar: a report of 125 cases. J Pediatr Pueric 2015; 28: 114–7. https://doi.org/10.1016/j.jpp.2015.02.008
[5]	Palmer LS. Hernias and hydroceles. Pediatr Rev 2013; 34: 457–64. https://doi.org/10.1542/pir.34-10-457
[6]	Sarr A, Sow Y, Fall B, Ze Ondo C, Thiam A, Ngandeu M, et al. The pathology of the peritoneovaginal canal in urological practice. Prog En Urol 2014; 24: 665–9. https://doi.org/10.1016/j.purol.2014.05.004
[7]	Guena MN, Zilbinkai FA, Amvene JM, Ngaroua N, Tchantcho BSN, Engoumou AS, et al. Ultrasound Aspects of Painful Bursae at the Ngaoundéré Regional Hospital, Cameroon. Health Sci Dis2019; 20: 44–9. https://doi.org/10.5281/hsd.v20i5.1557
[8]	Ndiaye M, DaMé I, Welle I. Pathology of the processus vaginalis in rural areas: epidemiological, clinical and therapeutic aspects. Uro'Andro 2018; 11: 4.
[9]	Ouattara K, Dafé S, Yakwe Y, Ciss C. Investigation into “large purses” in tropical zones. Black Africa medicine 1991: 4.
[10]	Diallo T, Barry MI, Bah M, Diallo T, Diallo A. Surgery for Adult Hydrocele at the Kolda RegionalHospital (Senegal) 2022; 23: 88–91. https://doi.org/10.5281/hsd.v23i1.3215
[11]	O Kone, A Kassogue, MT Coulibaly, I Sissoko, D Sangare, HJ Berthe, and al. Epidemiological, clinical and therapeutic study of hydroceles in three health districts of the Sikasso region/Mali. Ann Afr Med 2019; 13: 3513–8.
[12]	F Boukinda, G Nervetti. Vaginal hydrocele. A report of 55 surgically treated cases. Ann Urol2003; 37: 293–5. https://doi.org/10.1016/S0003-4401(03)00108-6
[13]	HM Tran, I MacQueen, D Chen, M Simons. Systematic Review and Guidelines for Managementof Scrotal Inguinal Hernias. J Abdom Wall Surg 2023; 2: 11195. https://doi.org/10.3389/jaws.2023.11195
[14]	B Shakiba, K Heidari, A Jamali, K Afshar. Aspiration and sclerotherapy versus hydrocoelectomyfor treating hydrocoeles. Cochrane Database Syst Rev 2014; 2014: CD009735. https://doi.org/10.1002/14651858.CD009735.pub2
[15]	K Shine, C Oppong, R Fitzgibbons, G Campanelli, W Reinpold, S Roll, and al. Technical aspects ofinguino scrotal hernia surgery in developing countries. Hernia 2023; 27: 173–9. https://doi.org/10.1007/s10029-022-02695-7

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APA Style

Traore, A., Ndiaye, M., Doukoure, M., Sonko, A. C., Ndiaye, M. D., et al. (2025). Management of Chronic Scrotal Swelling at the Urology Department of de la Paix Hospital of Ziguinchor. International Journal of Clinical Urology, 9(2), 214-218. https://doi.org/10.11648/j.ijcu.20250902.29

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ACS Style

Traore, A.; Ndiaye, M.; Doukoure, M.; Sonko, A. C.; Ndiaye, M. D., et al. Management of Chronic Scrotal Swelling at the Urology Department of de la Paix Hospital of Ziguinchor. Int. J. Clin. Urol. 2025, 9(2), 214-218. doi: 10.11648/j.ijcu.20250902.29

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AMA Style

Traore A, Ndiaye M, Doukoure M, Sonko AC, Ndiaye MD, et al. Management of Chronic Scrotal Swelling at the Urology Department of de la Paix Hospital of Ziguinchor. Int J Clin Urol. 2025;9(2):214-218. doi: 10.11648/j.ijcu.20250902.29

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@article{10.11648/j.ijcu.20250902.29,
  author = {Aboubacar Traore and Modou Ndiaye and Mohamed Doukoure and Awa Ciss Sonko and Modou Diop Ndiaye and Boubacar Fall},
  title = {Management of Chronic Scrotal Swelling at the Urology Department of de la Paix Hospital of Ziguinchor},
  journal = {International Journal of Clinical Urology},
  volume = {9},
  number = {2},
  pages = {214-218},
  doi = {10.11648/j.ijcu.20250902.29},
  url = {https://doi.org/10.11648/j.ijcu.20250902.29},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20250902.29},
  abstract = {Introduction: Chronic scrotal swelling is a common reason for consultation at Urology. Its global prevalence remains unknown. Among adults, it is often perceived as a shameful condition. Traditional treatments expose patients to potentially severe complications. This study aimed to assess the management of chronic scrotal swelling within our department. Methods: We conducted a four-year retrospective descriptive study (January 1, 2017–December 31, 2020). All patients who underwent surgery for chronic scrotal swelling at the Urology Department of De la Paix Hospital of Ziguinchor, were included. Data were collected from medical records. Variables studied included epidemiological, clinical, etiological, therapeutic, and evolutionary parameters. Results: A total of 67 patients were recorded (frequency: 23.3%). The mean age was 54.3 years for adults (range: 20–89 years) and 4.8 years for children (range: 7 months–12 years). Farmers were the most represented group (34.5%). A history of inguinal hernia repair was noted in 12.1%. Scrotal swelling was the main reason for consultation (83%). The right side was affected in 43%. The mean duration of symptoms was 5 years. Inguino-scrotal hernia was the most common etiology (53.4%), while a persistent peritoneo-vaginal duct (PPVD) was the sole cause in children. Bassini technique was used in 27.6% of cases of hernia. In-hospital follow up was performed for 24 hours in 63.8% of adults and 77.7% of children. At 3-month follow-up, outcomes were unremarkable in 96.5%. Complications occurred only on adults including operative wound infection, chronic pain with testicular hypotrophy, and one death. Conclusion: Chronic scrotal swelling can occur at any age and remains a frequent condition in urology. Diagnosis is primarily clinical, and surgery is essential but can lead to potential complications.},
 year = {2025}
}

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TY - JOUR
T1 - Management of Chronic Scrotal Swelling at the Urology Department of de la Paix Hospital of Ziguinchor
AU - Aboubacar Traore
AU - Modou Ndiaye
AU - Mohamed Doukoure
AU - Awa Ciss Sonko
AU - Modou Diop Ndiaye
AU - Boubacar Fall
Y1 - 2025/12/26
PY - 2025
N1 - https://doi.org/10.11648/j.ijcu.20250902.29
DO - 10.11648/j.ijcu.20250902.29
T2 - International Journal of Clinical Urology
JF - International Journal of Clinical Urology
JO - International Journal of Clinical Urology
SP - 214
EP - 218
PB - Science Publishing Group
SN - 2640-1355
UR - https://doi.org/10.11648/j.ijcu.20250902.29
AB - Introduction: Chronic scrotal swelling is a common reason for consultation at Urology. Its global prevalence remains unknown. Among adults, it is often perceived as a shameful condition. Traditional treatments expose patients to potentially severe complications. This study aimed to assess the management of chronic scrotal swelling within our department. Methods: We conducted a four-year retrospective descriptive study (January 1, 2017–December 31, 2020). All patients who underwent surgery for chronic scrotal swelling at the Urology Department of De la Paix Hospital of Ziguinchor, were included. Data were collected from medical records. Variables studied included epidemiological, clinical, etiological, therapeutic, and evolutionary parameters. Results: A total of 67 patients were recorded (frequency: 23.3%). The mean age was 54.3 years for adults (range: 20–89 years) and 4.8 years for children (range: 7 months–12 years). Farmers were the most represented group (34.5%). A history of inguinal hernia repair was noted in 12.1%. Scrotal swelling was the main reason for consultation (83%). The right side was affected in 43%. The mean duration of symptoms was 5 years. Inguino-scrotal hernia was the most common etiology (53.4%), while a persistent peritoneo-vaginal duct (PPVD) was the sole cause in children. Bassini technique was used in 27.6% of cases of hernia. In-hospital follow up was performed for 24 hours in 63.8% of adults and 77.7% of children. At 3-month follow-up, outcomes were unremarkable in 96.5%. Complications occurred only on adults including operative wound infection, chronic pain with testicular hypotrophy, and one death. Conclusion: Chronic scrotal swelling can occur at any age and remains a frequent condition in urology. Diagnosis is primarily clinical, and surgery is essential but can lead to potential complications.
VL - 9
IS - 2
ER -

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Author Information

Aboubacar Traore

Urology Department, Peace Hospital, Ziguinchor, Senegal;Department of Urology, Assane Seck University, Ziguinchor, Senegal

Contact Email

http://orcid.org/0009-0001-5177-3877
Modou Ndiaye

Department of Urology, Cheikh Anta Diop University of Dakar (UCAD), Dakar, Senegal

http://orcid.org/0000-0001-8402-5640
Mohamed Doukoure

Urology Department, Peace Hospital, Ziguinchor, Senegal;Department of Surgery, Gaston Berger University (UGB), Saint-Louis, Senegal

http://orcid.org/0009-0002-8537-8928
Awa Ciss Sonko

Urology Department, Peace Hospital, Ziguinchor, Senegal
Modou Diop Ndiaye

Urology Department, Peace Hospital, Ziguinchor, Senegal;Department of Urology, Assane Seck University, Ziguinchor, Senegal
Boubacar Fall

Urology Department, Peace Hospital, Ziguinchor, Senegal;Department of Urology, Assane Seck University, Ziguinchor, Senegal

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Figure 1

Figure 1. Distribution According to the Grade Achieved in Adults.

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APA Style

Traore, A., Ndiaye, M., Doukoure, M., Sonko, A. C., Ndiaye, M. D., et al. (2025). Management of Chronic Scrotal Swelling at the Urology Department of de la Paix Hospital of Ziguinchor. International Journal of Clinical Urology, 9(2), 214-218. https://doi.org/10.11648/j.ijcu.20250902.29

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Traore, A.; Ndiaye, M.; Doukoure, M.; Sonko, A. C.; Ndiaye, M. D., et al. Management of Chronic Scrotal Swelling at the Urology Department of de la Paix Hospital of Ziguinchor. Int. J. Clin. Urol. 2025, 9(2), 214-218. doi: 10.11648/j.ijcu.20250902.29

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AMA Style

Traore A, Ndiaye M, Doukoure M, Sonko AC, Ndiaye MD, et al. Management of Chronic Scrotal Swelling at the Urology Department of de la Paix Hospital of Ziguinchor. Int J Clin Urol. 2025;9(2):214-218. doi: 10.11648/j.ijcu.20250902.29

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@article{10.11648/j.ijcu.20250902.29,
  author = {Aboubacar Traore and Modou Ndiaye and Mohamed Doukoure and Awa Ciss Sonko and Modou Diop Ndiaye and Boubacar Fall},
  title = {Management of Chronic Scrotal Swelling at the Urology Department of de la Paix Hospital of Ziguinchor},
  journal = {International Journal of Clinical Urology},
  volume = {9},
  number = {2},
  pages = {214-218},
  doi = {10.11648/j.ijcu.20250902.29},
  url = {https://doi.org/10.11648/j.ijcu.20250902.29},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20250902.29},
  abstract = {Introduction: Chronic scrotal swelling is a common reason for consultation at Urology. Its global prevalence remains unknown. Among adults, it is often perceived as a shameful condition. Traditional treatments expose patients to potentially severe complications. This study aimed to assess the management of chronic scrotal swelling within our department. Methods: We conducted a four-year retrospective descriptive study (January 1, 2017–December 31, 2020). All patients who underwent surgery for chronic scrotal swelling at the Urology Department of De la Paix Hospital of Ziguinchor, were included. Data were collected from medical records. Variables studied included epidemiological, clinical, etiological, therapeutic, and evolutionary parameters. Results: A total of 67 patients were recorded (frequency: 23.3%). The mean age was 54.3 years for adults (range: 20–89 years) and 4.8 years for children (range: 7 months–12 years). Farmers were the most represented group (34.5%). A history of inguinal hernia repair was noted in 12.1%. Scrotal swelling was the main reason for consultation (83%). The right side was affected in 43%. The mean duration of symptoms was 5 years. Inguino-scrotal hernia was the most common etiology (53.4%), while a persistent peritoneo-vaginal duct (PPVD) was the sole cause in children. Bassini technique was used in 27.6% of cases of hernia. In-hospital follow up was performed for 24 hours in 63.8% of adults and 77.7% of children. At 3-month follow-up, outcomes were unremarkable in 96.5%. Complications occurred only on adults including operative wound infection, chronic pain with testicular hypotrophy, and one death. Conclusion: Chronic scrotal swelling can occur at any age and remains a frequent condition in urology. Diagnosis is primarily clinical, and surgery is essential but can lead to potential complications.},
 year = {2025}
}

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