Acute scrotum (ICD-10-GM N50.9: disease of male genital organs, unspecified) is acute (sudden) pain of the scrotum (scrotum) associated with redness and swelling.
Acute scrotum is an emergency!
In pediatric patients, testicular torsion is usually the cause. In adults, inflammation (epididymitis/epididymitis: 28.4% or epidydymo-orchitis/combined inflammation of the epididymis and testis (orchis): 28.7%) is most often the cause of acute scrotum.
Peak incidence of testicular torsion: maximum occurrence is during the 1st year of life and puberty.
The incidence (frequency of new cases) of testicular torsion in men younger than 25 years is approximately 1 case per 4,000 population per year.
Course and prognosis: In 20-25% of cases, testicular torsion (ICD-10 N44.0 – twisting of the testicular vessels) is the cause of acute scrotum. This causes the blood supply to be interrupted. Irreversible damage to the testicular parenchyma (testicular tissue) due to ischemia (reduced blood supply) occurs after only 4 hours! The ischemia time in children is a maximum of 6-8 hours, for newborns or infants this period is much shorter. Medical clarification/intervention is required immediately (emergency!) In less than 1%, male fertility is impaired as a result of testicular torsion. In adults, inflammation (epididymitis/epididymitis: 28.4% or epidydymo-orchitis/combined inflammation of the epididymis and testis (orchis): 28.7%) is most often the cause of acute scrotum, the course and prognosis of which depends on the diagnosis. Therapy consists of general measures such as elevation and cooling, as well as the administration of antibiotics and analgesics (painkillers)/antiphlogistics (anti-inflammatory drugs).
