Acute Scrotal Pain in Children – Ten Years’ Experience

Abstract

Introduction: Acute scrotal pain sometimes requires prompt surgical intervention and therefore accurate diagnosis of different etiologies of acute scrotal pain has great therapeutical and prognostic significance. The aim of this study was to analyze the incidence, symptomatology and results of treatment of acute scrotal pain in children. Material and Method: The study included patients hospitalized at the Pediatric Surgery Clinic with a diagnosis of acute scrotal pain. We retrospectively analyzed anamnestic data (age of patient and duration of anamnesis prior to admission), clinical parameters obtained during physical examination, mode of treatment (operative or medical), intraoperative findings and (postoperative) treatment. Results: The study included 256 patients with acute scrotal pain, aged from several hours up to 17 years of age (average 9.73 years). The average duration of symptoms prior to admission was 56.74 h. Acute epididymitis was diagnosed in 110 patients (43.0%), torsion of the testicular appendage in 104 patients (40.6%), torsion of the testis in 30 patients (11.7%) and other pathologies in another 12 patients. 166 patients (64.8%) underwent surgery, 42 patients with orchiepididymitis (38.2%), 92 patients with torsion of the testicular appendage (88.5%), and 16.6% of the patients with other pathologies. 22 patients with torsion of the testis underwent surgery (73.3%), while the rest of the 8 patients underwent manual detorquation of the testis. Conclusion: Regardless of the etiology of the acute scrotal pain, it is of great importance that the patient seeks medical assistance promptly. It is therefore important to educate the parents and patients about the problems related to acute scrotal pain.

A Study of Acute Scrotum in Pediatric Patients

“…In our hospital, ultrasound with an expert sonologist, is only available during day time and not during the late afternoon and at night. As pain and swelling of scrotum are the most common symptoms in testicular torsion and also there are paucity of diagnostic tools, so some studies suggest early surgical exploration [15][16][17] , as we have done this for the indicated patients in our study.…”

“…Acute pediatric scrotal pain sometimes requires prompt surgical intervention and therefore accurate diagnosis of different etiologies of acute scrotal pain has great therapeutic and prognostic significance 1 …”

Cocuklarda Nadir Bir Bruselloz Komplikasyonu: Epididimoorsit

“…Akut skrotal ağrı nedenleri arasında; akut epididimit (%43), testiküler apandiks torsiyonu (%40,6), testis torsiyonu (%11,7) ve diğer nedenler (%4,7) yer almaktadır (6). Epididimorşitin etiyolojisinde kabakulak virüsü, Escherichia coli, Klebsiella pneumonia, Staphylococcus aureus ve streptokoklar rol oynamaktadır.…”

The aetiology and current management of prepubertal epididymitis

“…Torsion of testicular appendix, testicular torsion and acute epididymitis (AE) have been shown to be the major differential diagnoses in several cohorts. [1][2][3][4] The management of each patient depends on the individual clinical manifestations, laboratory and sonographic findings. Although it has been shown that colour Doppler sonography can identify testicular torsion in boys reliably, 5 the surgical exploration remains the gold standard diagnostic tool so as to maximise the chances of testicular salvage in case of testicular torsion.…”

“…In different series it ranges from 3.7% to 71% of children presenting with acute scrotum. [1][2][3][4][5][6][7][8] A bimodal age distribution of epididymitis has been reported in many series, with peak incidence in infancy and mainly the age group of 10-12 years. [7][8][9][10] In our district hospital we encountered six consecutive cases of AE in prepubertal boys over a period of two months.…”