The inguinal suppurative funiculitis. Clinical observation review

Inguinal suppurative funiculitis (ISF) is a rare disease with unclear etiopathogenesis. In this regard, each case ISF deserves attention and discussion. The 2 cases of ISF, namely the patient aged 42 years with latent urogenital infection and the patient aged 63 years, who underwent radical prostatectomy complicated by septic pelvic lymphocele are described in this article. The ISF proceeded as acute surgical disease inguinal-scrotal region and caused considerable diagnostic difficulties. Probable pathological substrate of the ISF in the presented observations were congenital and reactive funiculopyocele. From a pathogenetic point of view ISF arose as a complication of acute deferentitis, developed on the background of urogenital infection (1st case) and trivial purulent pelvic cellulitis (2nd case). It is assumed that the causative infection from the urethra, accessory sex glands and pelvic tissue has spread to the sheath of the spermatic cord through the lumen of the vas deferens or the fascial case (per canalicular way) and then to a vas deferens in spermatic cord for follow-up (per continuitatem). Diagnosis ISF was conducted using high-resolution ultrasound and MRI of the inguinal canal and scrotum. Final verification of diagnosis was carried out intraoperative and pathological methods. ISF must be differentiated from acute diseases inguinal-scrotal region, and above all, with strangulated inguinal hernia, acute epididymitis and torsion of the testicle. The treatment of the ISF was surgical (revision of the inguinal canal, opening and drainage membranes of the spermatic cord) with a favorable outcome. The various ways of etiopathogenesis, clinical and radiological diagnosis and treatment of the ISF presented in the literature are discussed in this article.