Feature Article

Scrotal swellings: an approach for GPs

Feature Article

Scrotal swellings: an approach for GPs

David Golovsky

Abstract

A careful history and physical examination are keys to accurately diagnosing the cause of a scrotal swelling and implementing an appropriate course of action.

Key Points

  • The keys to diagnosis of a scrotal swelling are an adequate history and a careful physical examination.
  • Swellings in the scrotum are either acute or chronic.
  • An acutely swollen painful testis held high with an overlying redness of the scrotum in an older child or adolescent is testicular torsion until proven otherwise.
  • Epididymo-orchitis is quite uncommon in children and torsion is less common in adults. If the diagnosis of epididymo-orchitis is uncertain, surgery is indicated to exclude testicular torsion.
  • A patient with any mass inside the actual testis requires urgent referral to a urologist because it is a tumour until proven otherwise.