Includes Torsion & Epididymitis-Orchitis.
Ask men with lower abdominal pain, “Are you sure it’s not your testicles?”
- Most calmly insist “they’re OK.”
- If in doubt, examine for scrotal swelling & testicular tenderness
Torsion — Presents with abrupt onset, severe pain, usually vomiting
- Swollen scrotum, very tender testis
- Absent Cremasteric reflex
- Send to ER for stat surgery
Epididymitis-Orchitis
- Onset gradual
- Varying degrees of swelling & tenderness
- Cremasteric reflex present
- Mild-moderate cases: Test for Gonorrhea & Chlamydia, treat empirically pending results
- Severe cases — send to ER to R/O Torsion, or to admit for IV Tx against gangrene-causing anaerobes