Testicular Pain

HISTORY:

‍RightLeft testicular pain for ‍ ‍hoursdays

Onset: ‍gradualsudden, following ‍

Radiation: ‍none

Severity: ‍mildmoderatesevere, ‍012345678910 / 10

Pattern: ‍constantintermittent

Worsening factors: ‍none

Treatments tried: ‍none, ‍effectiveineffective

‍swelling

‍redness

‍fever, up to ‍°, over ‍ ‍hoursdays

‍abdominal pain

‍nausea

‍vomiting, ‍ episodes ‍per day, ‍, ‍hematemesis

‍hematuria

‍dysuria

‍urinary frequency



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Abdomen: ‍softsemi-softtense, ‍non-tender ‍, ‍non-distended, ‍

CVA tenderness: ‍negativepositive on Rpositive on L

Genital: ‍normal, testicles ‍normal, penis ‍normal



ASSESSMENT:

‍Epididymitis ‍likelysuspectedpossible

DDx: ‍



PLAN:

- Urinalysis

- Urine culture

- STI testing for chlamydia and gonorrhea

- Blood work: ‍CBC, ‍CRP, ‍creatinine

- Scrotal ultrasound

- Testicular doppler if torsion suspected

- ‍Analgesics

- ‍Antibiotics

- Ice packs

- Referral to urologist

- Follow-up in ‍ ‍daysweeks

- Return if pain worsens, if new symptoms develop such as fever or swelling, or if symptoms do not improve with treatment

- Go to ER if severe pain or sudden onset of symptoms occurs