UROLOGY

Question 1

A adolescent boy comes in with severe testicular pain which started suddenly. He has no fever and hasn’t had any discomfort with urination or cloudy urine. He has had no neck swelling and is fully vaccinated. On exam, his testis is swollen, exquisitely tender, and appears to be higher and more horizontal than the other side. The cord is not tender.

1. Likely diagnosis
2. Dx
3. Tx

Answer 1

1. Testicular torsion
   - sudden exquisite testicular pain & tenderness
   - “high riding” and with a “horizontal lie”
   - no fevers, pyruria, non-tender cord
2. Dx:
   Urologic emergency– time wasted by tests = malpractice
3. Tx: Immediated surgical intervention
   - After untwisting testis, orchiopexy is done
   - Many urologists fix both sides