From the Guidelines
Fistulas involving the scrotum can be caused by Crohn's disease, which can lead to perianal fistulas that extend to the scrotum, as well as other conditions such as urethral strictures, surgical complications, infections, and hidradenitis suppurativa. The most common causes of fistulas involving the scrotum include:
- Crohn's disease, which can lead to perianal fistulas that extend to the scrotum 1
- Urethral strictures or trauma that create abnormal passages between the urethra and scrotum
- Surgical complications following procedures like hernia repairs or prostatectomies
- Infections such as tuberculosis, actinomycosis, or severe bacterial infections that form abscesses
- Hidradenitis suppurativa, a chronic inflammatory skin condition affecting apocrine gland-bearing areas Other potential causes include malignancies, particularly colorectal or urological cancers that invade surrounding tissues; radiation therapy complications; and congenital abnormalities present from birth. Management typically involves identifying and treating the underlying cause, which may require antibiotics for infections, surgical intervention to repair the fistula, or medical therapy for conditions like Crohn's disease (including biologics like infliximab) 1. Proper diagnosis often requires imaging studies such as MRI, fistulography, or endoscopic evaluation to determine the exact anatomy and origin of the fistulous tract before definitive treatment can be initiated. According to the most recent guidelines, the medical management of fistulizing Crohn's disease should focus on the use of biologics and other pharmacologic therapies to induce and maintain remission 1.
From the Research
Causes of Fistulas Involving the Scrotum
- Mucinous adenocarcinoma of the scrotum can cause scrotal fistulas, as reported in a case study 2
- Tuberculosis can also cause scrotal fistulas, although this is not directly mentioned in the provided studies, it is mentioned that scrotal fistulas often represent secondary lesions of tuberculosis 2
- There is no direct evidence in the provided studies that links the causes mentioned in the other studies to fistulas involving the scrotum, as the other studies focus on rectourinary fistulas 3, genital fistulas 4, urological fistulas 5, and rare causes of genital fistula 6
Related Conditions
- Rectourinary fistulas can be caused by benign or malignancy-related conditions, including Crohn's disease, trauma, perirectal sepsis, iatrogenic injury, neoplasm, radiation, and surgery 3
- Genital fistulas can be caused by obstetrical causes, gynaecological surgery, and other factors like vaginal procedure, coitus, trauma, etc. 4
- Urological fistulas can result from surgical complications and/or inadequate perinatal obstetric healthcare 5
- Rare causes of genital fistula include traumatic accidents, traumatic sexual violence, traumatic injuries caused by traditional healers, unsafe abortion, radiation, complications of HIV infection, and congenital abnormality 6