American Society of Hirudotherapy

Scrotal hirudiniasis: the mysterious migration of a leech into the scrotum

Case report published in Clinical Case Reports (2026)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportSafety & Infection ControlChakroborty P et al. · Clinical case reports, 2026

Abstract

Hirudiniasis, or leech infestation, is a rare parasitic condition typically involving external skin or mucosal surfaces. We report a case of scrotal hirudiniasis, an 11 cm long leech discovered within the scrotal sac of a 15-year-old male. He initially developed hematuria due to periurethral leech attachment, which resolved following catheterization and bladder irrigation. A week later, he presented with acute scrotal pain and swelling. Ultrasound revealed a tubular, mobile structure near the left vas deferens. Surgical exploration identified an 11 cm leech within the tunica vaginalis, without any external entry wound or urethra-cutaneous fistula. Two plausible routes of entry are suggested: retrograde movement via the vas deferens or migration through perineal fascial planes following urethral breach. This case underscores the need to consider unusual parasitic causes in patients presenting with acute scrotum in endemic regions.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal Article

Summary

Unusual case of scrotal hirudiniasis from migration of an aquatic leech — emergency-removal protocol described with surgical excision under local anesthesia.

Why This Matters for Hirudotherapy

This article reports a case of scrotal hirudiniasis in a 15-year-old male, in whom an 11 cm leech was surgically discovered within the tunica vaginalis after presentation with acute scrotal pain and swelling, preceded a week earlier by hematuria due to periurethral leech attachment that resolved following catheterization and bladder irrigation. Two plausible routes of entry are suggested: retrograde movement via the vas deferens or migration through perineal fascial planes following urethral breach. While this involves a leech, the context is accidental parasitic infestation rather than therapeutic hirudotherapy or leech secretome research. The article documents an unusual parasitological event in an endemic region, with no discussion of leech biology, therapeutic mechanisms, or controlled leech application, and its relevance to ASH's domain is minimal.

Citation

Scrotal hirudiniasis: the mysterious migration of a leech into the scrotum.

Chakroborty P et al. · Clinical case reports, 2026

DOI

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.