LEFT-SIDED SCROTAL PYOCELE WITH CONTRALATERAL MINIMAL HYDROCELE IN AN ELDERLY DIABETIC MALE: A CASE REPORT

Scrotal pyocele is an uncommon urological emergency characterized by accumulation of purulent fluid within the tunica vaginalis surrounding the testis. It commonly develops as a complication of epididymo-orchitis, infected hydrocele, trauma or intra-abdominal infections. Early diagnosis and prompt intervention are essential to prevent serious complications such as Fournier’s gangrene and testicular damage. We report a case of a 70-year-old male with newly detected uncontrolled Type II Diabetes Mellitus who presented with bilateral scrotal swelling and pain, predominantly on the left side. Ultrasonography revealed gross left-sided hydrocele with dense echogenic contents suggestive of pyocele along with mild right hydrocele. The patient underwent left orchidectomy with excision of infected spermatic fascial layers and right-sided Jaboulay’s eversion of sac under spinal anaesthesia. Post-operative recovery was satisfactory with healthy wound healing and no complications. This case highlights the importance of early clinical and ultrasonographic diagnosis followed by timely surgical management in elderly diabetic patients presenting with acute scrotal swelling.