Table of Contents

Introduction
Why is it done?
Complications
Mx in ED

scrotal infusion with saline

see also:

Introduction

also called “saline ball injection”, it seems that the practice of infusing 500-1000mL of warmed normal saline into the scrotum usually using a 18G IV cannula (usually takes about 1hr per 500mL) is increasing despite it being a highly risky behavior with potential serious consequences
these patients may present to the ED as an “acute scrotum ?testicular torsion” but once the history is attained it will be clear that torsion is not the issue

THIS IS NOT AN ADVISABLE PRACTICE - there may be serious long term consequences or rarely, it may be fatal

Why is it done?

some men wish to make their scrotums appear larger - even if only for 2-3 days when it returns to usual size if there are no complications
sexual fetish
may improve sexual stimulation
may be used by a dominant party on a submissive

Complications

ongoing pain and discomfort
scrotal cellulitis
- sterile technique may not have been perfect
scrotal abscess
rupture of scrotum
rupture of testicle or other testicular complications
- if they inject into the testicle instead of the scrotum
Fournier's gangrene
- tissues become necrosed and may be fatal
permanent infertility
scrotal emphysema
- due to air being trapped
air embolism

Mx in ED

assess for possible cellulitis, sepsis or Fournier's gangrene and manage these on their merits
consider emergent ultrasound
consider empirical / prophylactic broad spectrum antibiotics