The Diagnosis and Management of Scrotal Pain
Being called upon to evaluate a young man with scrotal pain may not at first seem to represent a glamorous request for consultation. Yet its evaluation, diagnosis, and correct management represent an increasingly rare opportunity in modern medicine: one has the chance of making a diagnosis and managing a patient on the basis of nothing more than a well taken history and a careful physical examination. For the patient who presents with scrotal pain of less than 8–12 h duration, an experienced clinician can make a correct diagnosis based on the history, physical examination, and a urinalysis. However if the pain persists beyond 12 h, the findings on physical examination become less clear and, in this setting, it has proven useful to use Doppler sonography. Even experienced clinicians must exercise caution in the evaluation of these patients because if the diagnosis of testicular torsion cannot be excluded with confidence, emergent scrotal exploration is warranted. Torsion of the testis with infarction and parenchymal loss remains a leading source of litigation in pediatric surgical practices.
KeywordsSpermatic Cord Urethral Stricture Testicular Torsion Tunica Albuginea Ureteral Calculus
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