Testicular Torsion and Prostatitis

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)