This review details the evaluation and management of the acute scrotum in the emergency department setting and emergent penile complaints in adults, with an emphasis on the most serious and most common conditions. Other emergent conditions include necrotizing fasciitis of the perineum (Fournier disease), incarcerated or strangulated inguinal hernia, and genitourinary (GU) trauma. Emergency practitioners need to be most concerned with the entities that, if left untreated, can result in ischemia and necrosis of the penis. Basic anatomy and bedside evaluation are reviewed. Acute scrotal and penile pain and GU trauma are discussed in terms of assessment and stabilization, diagnosis, and treatment and disposition.
This review contains 5 figures, 19 tables, and 71 references.
Keywords: Acute scrotal pain, testicular torsion, priapism, Peyronie disease, paraphimosis, phimosis, balanitis, posthitis, epididymitis
The Diagnosis and Treatment of the Acute Scrotum in Children and Adolescents