An Accurate Diagnostic Pathway Helps to Correctly Distinguish Between the Possible Causes of Acute Scrotum

Journal Title: Oman Medical Journal - Year 2018, Vol 33, Issue 1

Abstract

Objectives: We sought to identify a simplified approach for the rapid differential diagnosis of patients presenting with acute scrotum. Methods: A total of 440 patients referred to the emergency department of the University Hospital of Bern, Switzerland, with acute scrotum between 2003 and 2013 were retrospectively analyzed. Simple and multiple binary logistic regression analyses were used to evaluate clinical and laboratory parameters that may help to distinguish between genital/paragenital infection and acute testicular torsion. Results: Over half (58.4%; 257/440) of the patients were diagnosed with genital/paragenital infection, 11.8% (52/440) with chronic testicular pain, 9.5% (42/440) with acute testicular torsion, 4.3% (19/440) with a testicular cancer, and 2.5% (11/440) with symptomatic distal ureterolithiasis. In multivariate analysis, a positive Prehn’s sign was predictive of testicular torsion, whereas fever, dysuria, high leucocyte counts in blood and/or urine, high blood C-reactive protein, and burning pain were predictive of genital/paragenital infection. Color Doppler ultrasound did not help to distinguish between torsion and infection. Conclusions: An accurate diagnostic pathway helps to correctly distinguish between the possible causes of acute scrotum. However, none of the examinations performed could reliably distinguish between acute torsion and other causes of acute scrotum. Therefore, immediate surgical exploration of the testis is mandatory if torsion cannot be ruled out.

Authors and Affiliations

Beat Roth, Ioannis Giannakis, Meret Elisabeth Ricklin, George Niklaus Thalmann, Aristomenis Konstantinos Exadaktylos

Keywords

Related Articles

Burnout Syndrome Among Primary Care Physicians in Oman

Objectives: Medical professionals are exposed to many job stressors everyday, which can lead to psychological disturbances as well as burnout syndrome. We sought to assess the level of burnout among primary care physicia...

The Effect of Group Discussion-based Education on Self-management of Adults with Type 2 Diabetes Mellitus Compared with Usual Care: A Randomized Control Trial

Objectives: We sought to determine the effect of group discussion-based education on the self-management capability of patients with type 2 diabetes in Iran. Methods: This randomized control trial was conducted on 90 pat...

Glycemic Control in Patients with Diabetes across Primary and Tertiary Government Health Sectors in the Emirate of Dubai, United Arab Emirates: A Five-Year Pattern

Objectives: In the UAE, the comparative prevalence of diabetes is reported as 18.98%, but there are very few studies evaluating glycemic control. Attaining the optimum glycemic control has been a global challenge over th...

Development and Implementation of Maternity Dashboard in Regional Hospital for Quality Improvement at Ground Level: A Pilot Study

Objectives: We sought to develop and implement a Maternity Dashboard to improve the quality of health care at the ground level. Methods: We conducted a prospective, descriptive cross-sectional study, involving patients w...

Primary Hypothalamic Lymphoma in an Adult Male: A Case Report and Literature Review

Primary central nervous system lymphoma is a well-known entity. However, the hypothalamus is a rare location, especially in adults. Few cases of secondary lymphomas have been reported. We report a case of primary hypotha...

Download PDF file
  • EP ID EP259090
  • DOI 10.5001/omj.2018.10
  • Views 94
  • Downloads 0

How To Cite

Beat Roth, Ioannis Giannakis, Meret Elisabeth Ricklin, George Niklaus Thalmann, Aristomenis Konstantinos Exadaktylos (2018). An Accurate Diagnostic Pathway Helps to Correctly Distinguish Between the Possible Causes of Acute Scrotum. Oman Medical Journal, 33(1), 55-60. https://europub.co.uk/articles/-A-259090