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BACKGROUND: Absence of the testis in the scrotum is a common paediatric surgical disorder seen in our practice. OBJECTIVE: To examine the presentation and treatment of the empty scrotum and postulate on the aetiology of the condition. DESIGN: A ten year retrospective study (September 1998 - August 2008). SETTING: Olabisi Onabanjo University Teaching Hospital, Sagamu. METHODOLOGY: Case notes of children managed for empty scrotum during the study period were retrieved from the medical record department of the hospital. Data obtained included age of patient, at presentation, age at surgery, side of scrotum affected, investigations carried out, type of surgery done and outcome of treatment within 6 months of follow-up period. The data obtained were presented in tables and figures. RESULTS: A total of 86 children were managed for empty scrotum during the study period. In 30 (34.9%) patients, the condition was discovered at birth while in 56 (65.1%) children it was discovered during early childhood period. Age range was 1-12 years with a median of 4 years. 36 (41.9%) presented within the age of 2 years while 50 (58.1%) cases presented above 2 years. The scrotum was empty on the right side only in 49 (57%) cases, on the left side in 26 (30.2%) patients. The scrotum was empty bilaterally in 11 (12.8%) patients. Undescended testes accounted for 68 (79.1%), retractile testis occurred in 14 (16.3%) and 4 (4.7%) were iatrogenic. Investigations carried out in all the patients included full blood count, haemoglobin genotype, urinalysis and electrolytes, urea and creatinine assay. Groin exploration and orchidopexy was done in 72 (83.7%) patients; of which 13 (18.1%) had surgery at the age of 2 years; while surgery was done in 15 (20.8%) patients at 3 years. Forty-four (61.1%) of the treated patients had groin examination above 3 years of age. Only 40 (55.6%) of the operated cases were seen during the six months follow-up period. In 31 (77.5%) of the patients seen during follow-up, the testes were of normal volume and consistency while in 9 (22.5%) of the patients, the testes had shown significant reduction in volume when compared with the contralateral normal side. No death was recorded. CONCLUSION: The study showed that most of the children presented late (>2 years) for consultation at the hospital. Inferentially, empty scrotum was caused mostly by undescended testes. Greater numbers of patients may obtain normal testes after treatment if they reported earlier to the hospital.

Pattern of Presentation and Management of the Empty Scrotum In Children: A Ten Year Review At A Southwestern Tertiary Hospital In Nigeria