How is acute scrotum treated?

Updated: Jan 02, 2020
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Of cases of acute scrotum, 90% are caused by epididymitis, torsion of the spermatic chord, and torsion of a testicular appendage.

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. Consultation with a urologist is mandatory in all but the most clear-cut cases for operative salvage of the torsed testicle.

The surgical intervention is detorsion and orchidopexy, with orchidopexy of the contralateral side (because this side is predisposed to torsion at a later date).

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