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)