08.04.2019 - By Zack Olson, MD and Michael Estephan, MD
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)