Testicular Torsion

History

* Pain in the testicles * Referred pain in the flank or lower abdomen* Usually sudden and severe* Usually WITHOUT urinary symptoms

Exam

* Asymmetric testicular lie* High riding testicle* Tenderness and swelling of the testicle itself* Cremasteric reflex

Testing

* Testicular Ultrasound

Treatment

* Immediate call to urology when suspected* Manual detorsion (“Open the Book”)

Prostatitis

History

* Pelvic pain* Pain with sex* Urinary symptoms* Fevers and chills

Exam

* Tenderness of the prostate/epididymis/testicle

Testing

* Urinalysis* Generally a clinical diagnosis

Treatment

* Commonly sexually transmitted in young men* Commonly E coli in older men* Bactrim or Fluoroquinolones

Additional Reading

* Testicular Torsion (EM Clerkship)* EMRA Antibiotic Guide (Amazon)