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Requires surgical exploration if unable to confidently exclude testicular torsion May be difficult to distinguish from testicular torsion
#PAINFUL LUMP ON TESTICLE FREE#
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A normal urine does not exclude epididymo-orchitis.Urine chlamydia and gonorrhoea PCR testing (if STI clinically suspected).Colour doppler flow ultrasound may assess blood flow, anatomy, and may localise swelling and fluid collections.Once testicular torsion and irreducible hernia have been confidently excluded, ultrasound may be considered if the diagnosis remains unclear.Blood tests, ultrasound and Doppler ultrasound are not useful in the acute setting.Usually sudden Severe May radiate to iliac fossa or thighĬan extend across midline and into perineum, groin, penis Common causes of delay include location of presentation, use of ultrasound, and transferring to a tertiary centre Delays in surgical management of testicular torsion result in higher rates of testicular loss (>40%).The most common causes of acute scrotal pain and/or swelling are torsion of the testicular appendage (appendix testis), epididymitis and testicular torsion.Ultrasound should only be considered in selected cases, after surgical assessment.Surgical evaluation should be undertaken in all cases where testicular torsion cannot be confidently excluded.It requires immediate referral to a surgeon Penis & foreskin Acute abdominal pain Key Points