Causes of Scrotal Bleeding

As I mentioned to some of you yesterday, I have found it quite interesting that one of the greatest sources of hits to our site is from various search engines where people are looking for causes of Scrotal Bleeding. This is thanks to the Flash's piece on the shorn scrotum. I'm sure that it is also partly due to the fact that there is not a lot of material out there on scrotal bleeding. When I see these hits from the search engines, I just can't help but picture an intern getting a call in the middle of the night from the floor or ER to go see a patient with a bleeding scrotum that just won't stop. I thought we should do our best to give help on this subject on which there is obviously a deficiency of literature available. So I will get the ball rolling (pun intended), but will also count on input from the bossman who is the only member of the CC who can proudly boast that he has intentionally caused bleeding of the genitalia of any kind, through circumcision, on a another member of the CC.

Trauma- Since trauma is by far the most common cause of scrotal bleeding the discussion may need to focus on what to do about it.
Obviously any large trauma to the genitalia would require the consultation of a urologist or general surgeon, and therefore be out of the scope of this text.
For smaller infractions however, you have to address a key point. Is the degree of bleeding appropriate for the injury? If so then a thourough exam and wound closure may be all that is required. As noted by the Flash in his experience, chemical cauterization was attempted with apparent initial success. But when he began bleeding again, the area was sutured, with success.
If the scrotal bleeding appears to be greater than you would expect from the size of the injury you have to ask yourself what else is going on.
-Is there a clotting disorder? I believe brad told me that this guy was on coumadin which may have contributed, or what about haemophilia, von Willebrand's disease, and thrombocytopenia? Does he have Liver disease?
Or, as the bossman did mention, there could be vascular ectasia, and he therefore gets partial credit, but did not mention by name a specific disorder known as Angiokeratoma of Fordyce. This is a condition in which you may see typically asymptomatic, 2- to 5-mm, blue-to-red papules with a scaly surface located on the scrotum, shaft of penis, labia majora, inner thigh, or lower abdomen. It is benign and the main complication is bleeding. Spontaneous resolution has not been described and it has been treated with excision, cryotherapy, electrocautery, and laser treatment. Another related disorder is known as Angiokeratoma Circumscription, also here is an interesting case of case of angiokeratoma corporis diffusum.

That is about all I could find today. Luckily I have not encountered any bewildering cases of scrotal bleeding, but hopefully when I do, I will at least be able to sound smart if I can remember to say "He could have Angiokeratoma of Fordyce"

Whoa Nelly!! I almost forgot the Classic "There's Something About Mary" Trapped Zipper Syndrome! Obviously that won't be a mystery but, here are some Clinical Practice Guidelines Man, I'm glad I didn't let someone else have that one.