• R Lazarov, G Stapper, and M T Lock.
• Afd. Urologie, Universitair Medisch Centrum Utrecht, Postbus 85.500, 3508 GA Utrecht.
• Ned Tijdschr Geneeskd. 2003 Jul 19;147(29):1389-93.

AbstractFive adult men, aged 34, 33, 31, 56 and 52 years respectively, were admitted with acute scrotal pain. Testicular torsion was eventually diagnosed in all the patients. Two of the patients were initially treated with antibiotics due to a suspected epididymitis. One of them required orchidectomy due to necrosis. The remaining patients underwent orchidofixation and their testicles could be preserved. The most important different diagnosis for acute pain and swelling of the testicle is either acute epididymitis or testicular torsion. The latter is uncommon in adult men. Using a physical examination to distinguish epididymitis from testicular torsion can be difficult. Doppler ultrasound is a reliable diagnostic tool for confirming testicular ischaemia. If the intratesticular flow is diminished or absent, then testicular torsion should be considered and this should be followed by immediate surgical exploration.

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