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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