Urology – Scrotal Pain: By Rob Siemens M.D.

medskl.com is a global, free open access medical education (FOAMEd) project covering the fundamentals of clinical medicine with animations, lectures and concise summaries. medskl.com is working with over 170 award-winning medical school professors to provide content in 200+ clinical presentations for use in the classroom and for physician CME.

Urology – Scrotal Pain
Whiteboard Animation Transcript
with Rob Siemens, MD
https://medskl.com/module/index/scrotal-pain
There are several serious conditions that cannot be missed that cause scrotal pain, including testicular torsion – usually presenting in younger males and Fournier’s gangrene – usually seen in diabetics.

When evaluating a patient with scrotal pain consider the age of the patient, the nature and duration of the pain and the presence or absence of a mass.

Acute, severe testicular pain in a child or adolescent is testicular torsion until proven otherwise; a scrotal ultrasound should be obtained to rule it out, and surgical exploration within 4 hours is necessary to avoid testicular loss.

In an elderly diabetic with overlying cellulitis be suspicious for Fournier’s gangrene. Look for black foul-smelling penile, scrotal, groin and perineal lesions representing a necrotising fasciitis. Urgent surgical debridement and broad-spectrum antibiotics are necessary.

A mass may be present in a patient with scrotal pain. A good history and physical examination plus a scrotal ultrasound will help rule in or out common causes including hydroceles and epididymal cysts. Also remember that while testicular cancer is usually painless, in men between 15 and 35 mild pain may be present. Urgent ultrasound and urology referral is necessary when testicular cancer is suspected.

An infectious epididymitis/orchitis is a common cause of acute or sub-acute scrotal pain. The diagnosis is generally made on history and physical examination.
Management includes rest, scrotal support, anti-inflammatories and antibiotics.

Also remember that scrotal pain may be referred from elsewhere. So remember to rule out common causes such as ureteric stones, inguinal pathology such as hernias and myo-fascial pain disorders.

Видео Urology – Scrotal Pain: By Rob Siemens M.D. канала Medskl.com