Testicular Compartment Syndrome (TCS) may complicate several intrascrotal conditions, but the diagnosis may be delayed or missed entirely.
Pathogenesis:
(1) increased venous resistance and/or extraluminal compression
(2) impairment of microcirculation with hypoxia and eventual ischemia
Conditions that can cause the compartment syndrome include:
(1) varicocele
(2) hydrocele, lymphocele or chylocele
(3) orchitis
(4) cryptorchidism
(5) scrotal hernia
(6) trauma
(7) torsion
(8) intratesticular arteriovenous fistula
(9) hematoma
(10) fasciitis
(11) other mass lesion
Clinical presentation may include:
(1) scrotal pain
(2) testicular swelling
Diagnosis:
(1) measured tissue pressure > 30 mm Hg
(2) reduction in blood flow on Doppler ultrasonography.
Management may include:
(1) incision of the tunica albuginea
(2) correction of the condition causing the compartment syndrome
Complications:
(1) testicular infarction
(2) ischemia/reperfusion injury
(3) infertility
