How are the diagnoses of epididymitis, torsion of the spermatic cord, and torsion of a testicular appendage differentiated?

Updated: Aug 27, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
  • Print
Answer

Among patients with acute scrotum, 90% of cases are caused by epididymitis, torsion of the spermatic cord, and torsion of a testicular appendage. Bacteria and leukocytes observed on a urethral Gram stain support a diagnosis of epididymitis, although some overlap may be observed between epididymitis, torsion of the spermatic cord, and torsion of a testicular appendage.

Consultation with a urologist is mandatory in all but the most clear-cut cases for operative salvage of the torsed testicle. Torsion of the spermatic cord must be assumed until proven otherwise, because unresolved torsion of the cord is likely to result in irreversible necrosis in less than 12 hours.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!