The prognosis of the acute scrotum varies depending on the cause. Time is the decisive factor in testicular torsion. The time interval between the occurrence of the symptoms and the surgical therapy should not exceed four hours in order to achieve a good prognosis.
If the treatment is carried out too late, irreparable damage to the testicular tissue occurs, which then has to be removed. Here the prognosis is poor due to the loss of fertility. The other causes of an acute scrotum usually have a better prognosis, as there is not such a narrow time window in their treatment.
An acute scrotum is not preventable in itself. If, however, an acute scrotum is present due to torsion of the testis, the testis not affected by this is also treated prophylactically by fixing it in its sheath, which greatly reduces the probability that the testis will also rotate.
Acute scrotum in a child
Although the acute scrotum in children has the same causes as in adults, more cases of critical torsion of the testis tend to occur in childhood because the excessive mobility of the testis in its sheaths, which then leads to the torsion of the testis, is usually congenital and therefore usually becomes symptomatic in childhood. A further peculiarity in children is that the younger the child, the shorter the time window of four to six hours for a therapy of testicular torsion.