Non-Traumatic Scrotal/Testicular Pain Clinical Pathway — Emergency Department

Complete History and Physical
History
  • Onset of symptoms
  • Location, radiation, severity of pain
  • Trauma
  • Nausea, vomiting, abdominal pain
  • Fever, dysuria
  • Penile discharge, STIs, sexual history
  • Analgesia, last dose
  • Last PO intake
Physical Examination
  • VS
  • Abdominal, flank tenderness
  • Tanner staging
  • Erythema, swelling, induration of scrotum
  • Testicle lie, size, consistency
  • Location of pain (corpus, posterior, superior, other)
  • Cremasteric reflex
  • Inguinal canal mass, reducibility
  • Urethral discharge
  • Prehn's sign – decreased pain with elevation of testis
  • Rash
  • Other signs of infectious disease
  • Other evidence of trauma