370 Scrotal Ultrasound in Young Men with Acute Scrotal Pain: A Retrospective Consecutive Case Series Audit

Abstract

Abstract Introduction Although not recommended by EAU guidelines, many men with acute scrotal pain undergo ultrasound (US) to screen for occult tumours. This has low diagnostic yield and must be weighed against the increased risks of coronavirus due to additional hospital attendances, inconvenience for the patient, and demand on NHS resources. We evaluated our case series to determine current practice and diagnostic yield. Method 141 consecutive cases of scrotal pain and/or swelling were identified from our Trust’s Surgical Assessment Unit (September-December 2020). Clinical diagnosis, and where performed, timing, indication and outcome of scrotal US was recorded. Results 109/141 patients underwent scrotal US; the only urgent clinical indications were suspected collection/abscess (5 cases) or testicular mass (4). Relative indications included uncertain diagnosis (27 cases), suspected missed testicular torsion (6) and suspected hernia (1). 66/109 US performed were for ‘soft’ indications, however one occult testicular tumour, one acute testicular torsion and two inguinal herniae were unexpectedly found. Conclusions Scrotal US changed immediate patient management in 1/109 cases (acute testicular torsion). Early outpatient US would be sufficient to diagnose occult testicular tumour, missed testicular torsions and groin herniae. There is too much reliance on US; more focus on history and examination is needed.