Evaluation of acute scrotal pain in adults
- Robert C Eyre, MD
Robert C Eyre, MD
- Associate Professor of Surgery
- Harvard Medical School
The spectrum of conditions affecting the scrotum and its contents ranges from acute pathologic events that require immediate surgical intervention to incidental findings that simply require patient reassurance.
This topic addresses the clinical evaluation and management of the acute scrotum, which is defined as moderate to severe scrotal pain that develops over the course of minutes to one to two days, in adults. Nonacute scrotal conditions in adults and scrotal disorders in children and adolescents are discussed separately. (See "Evaluation of nonacute scrotal conditions in adults" and "Evaluation of scrotal pain or swelling in children and adolescents".)
The testis, tunica vaginalis, epididymis, spermatic cord, and appendix testis are anatomic structures that may be involved in scrotal pathology (figure 1):
●The testis (testicle) is the male gonad responsible for production of sperm and androgens (primarily testosterone).
●The tunica vaginalis is a potential space that encompasses the anterior two-thirds of the testis. Different types of fluid may accumulate within the tunica vaginalis (eg, water with a hydrocele, blood with a hematocele, pus with a pyocele).To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- NORMAL ANATOMY
- PATIENT EVALUATION
- General approach
- - Diffuse scrotal pain
- - Localized scrotal pain
- Additional evaluation
- COMMON ETIOLOGIES
- Acute epididymitis or epididymo-orchitis
- - Clinical features and diagnosis
- - Management
- Testicular torsion
- - Clinical features and diagnosis
- - Management
- Manual detorsion
- LESS COMMON ETIOLOGIES
- Fournier's gangrene
- Torsion of the appendix testis
- Post-vasectomy pain
- Inguinal hernia
- Mumps orchitis
- Testicular cancer
- Henoch-Schönlein purpura
- Acute idiopathic scrotal edema
- Referred pain
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS