ED Pathway for Child with Acute Non-Traumatic Scrotal Pain

Disposition

Positive Ultrasound or High Probability per Urology Assessment

Negative Ultrasound

  • No need to consult with urology in low probability patient with a negative ultrasound
  • Discharge instructions and outpatient follow-up:
Epididymitis: Refer to urology if a pre-pubertal patient, otherwise follow up with pediatrician. A post-pubertal patient should receive PO antibiotics.
Torsion of Appendix Testis: Follow up with the pediatrician unless pain for 1-2 weeks, then needs urology referral.
Hernia: Urology referral
Communicating Hydrocele: Urology referral
Asymptomatic Hydrocele: Follow up with pediatrician
Varicocele: Refer to urology if clinically significant