• Frank L Cole and Robert Vogler.
• Division Head of Emergency Care, School of Nursing, University of Texas Health Science Center, Houston, USA. fcole@son1.nur.uth.tmc.edu
• J Am Acad Nurse Prac. 2004 Feb 1; 16 (2): 50-6.

PurposeThis article reviews the acute, nontraumatic scrotal conditions of testicular torsion, torsion of an epididymal or testicular appendage, and epididymitis in order to assist the nurse practitioner (NP) with arriving at a diagnosis. Primary and emergency care management are presented.Data SourcesSelected published literature in refereed journals and the authors' clinical experiences.ConclusionsSigns and symptoms of testicular pathologies can overlap, making diagnosis problematic. However, key features can raise the NP's index of suspicion for a particular diagnosis and can assist in selecting the most appropriate management strategy.Implications For PracticeAlthough these conditions are rarely fatal, they may carry a risk of morbidity in the form of testicular necrosis, infarction, or atrophy with concomitant infertility. Any patient with scrotal or testicular pain should be presumed to have testicular torsion until proven otherwise, as this condition carries a high degree of morbidity. The information gained through a thorough history and physical examination can assist in arriving at the proper diagnosis.

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