Urology: Scrotal Pain

Evaluation and management of genitourinary emergencies

“…9,19 Non-GU conditions may also cause referred scrotal pain and should be considered in the differential diagnosis; examples include inguinal herniation, abdominal aortic aneurysm, pancreatitis, peritonitis, intraperitoneal hemorrhage, polyarteritis nodosa, and renal colic. 9,19 Non-GU conditions may also cause referred scrotal pain and should be considered in the differential diagnosis; examples include inguinal herniation, abdominal aortic aneurysm, pancreatitis, peritonitis, intraperitoneal hemorrhage, polyarteritis nodosa, and renal colic.…”

“…Associated symptoms include nausea, vomiting, and anorexia. 9,19 Management Analgesia should be offered and administered as necessary. Historical information regarding any previous episodes of similar symptoms that might suggest intermittent episodes of waxing and waning torsion should be elicited, 16,18 as well as a previous episode of torsion requiring surgical fixation (orchiopexy); although rare, testes torsion can reoccur despite previous surgical intervention.…”

“…18,19 Ideally, the patient will undergo bilateral orchiopexy (because of the potential for future torsion in the unaffected testicle) with fixation; if the affected testicle doesn't regain bloodflow during initial surgical exploration the patient will instead undergo orchiectomy. 18,19 Ideally, the patient will undergo bilateral orchiopexy (because of the potential for future torsion in the unaffected testicle) with fixation; if the affected testicle doesn't regain bloodflow during initial surgical exploration the patient will instead undergo orchiectomy.…”

Qualitative and quantitative spermatic cord abnormalities at CT predict symptomatic scrotal pathology

“…In these cases, ultrasound is both sensitive and specific in the detection of the most common scrotal pathologies, such as epididymitis, orchitis, testicular torsion, and testicular neoplasm [ 3 – 7 ]. Unfortunately, scrotal pathology does not always present with a clear clinical picture, sometimes due to referred pain into the flank, pelvis, or hip; conversely, intra-abdominal and pelvic pathologies may result in scrotal or groin pain [ 8 , 9 ]. Additionally, in busy Emergency Departments, imaging may be ordered after only a rapid triage assessment, which could result in larger numbers in patients with scrotal pathology being screened with initial computed tomography (CT), bypassing sonographic evaluation [ 10 , 11 ].…”