BERK YASİN EKENCİ, METİN YIĞMAN, EMRE HEPŞEN, TAHSİN CAN ŞALAP, MEHMET ALTAN, AHMET NİHAT KARAKOYUNLU
Bulletin of Urooncology - 2025;24(2):47-51
OBJECTIVE In our study, we aimed to determine the prevalence of scrotal pain at initial presentation in patients with testicular cancer (TC) and to investigate the association of scrotal pain with the clinical, histological, and pathological features of TC. Materials and Methods Patients who underwent radical inguinal orchiectomy with a pathology of TC between 2015 and 2024 at two training and research hospitals were retrospectively analyzed. Data on patients’ age, initial presenting complaints, side of cancer, preoperative alpha-fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase levels, stage, presence of rete testis/lymphovascular/hilar invasion, tumor size, number of tumor foci, and histological subtypes were recorded. Patients were categorized into two groups based on whether they reported scrotal pain at the initial presentation. The relationship between scrotal pain and the aforementioned factors was statistically analyzed. RESULTS A total of 129 patients with TC were included, 63 (48.8%) reporting scrotal pain and 66 (51.2%) without pain. The primary complaints at presentation were-62 patients (48.1%) with painless scrotal swelling/irregularity, 48 patients (37.2%) with painful scrotal swelling/irregularity, and 15 patients (11.6%) with scrotal pain only. Additionally, two patients (1.6%) were diagnosed after abdominal masses were detected on computed tomography for abdominal pain, one (0.8%) was diagnosed during imaging for flank pain, and one (0.8%) was diagnosed during an infertility workup with scrotal ultrasonography. The mean age of the patients was 34 years. Pathology showed 61 (47.3%) seminoma and 68 (52.7%) non-seminoma cases. Rete testis invasion was present in 36 (27.9%) of cases and absent in 93 (72.1%) of cases. Lymphovascular invasion was present in 40 patients (31%) and absent in 89 patients (69%). Cancer staging classified 77 (59.7%) as stage 1, 42 (32.6%) as stage 2, and 10 (7.8%) as stage 3. Statistical analysis showed no significant association between scrotal pain and examined factors (p>0.05). CONCLUSION The signs and symptoms of TC should be well understood by all male patients and clinicians. It is important to keep in mind that scrotal pain can be observed in nearly half of TC patients. Prospective studies involving larger populations are needed to better understand the relationship between scrotal pain and TC.
