A 19-year-old male college student returns from spring break in Fort Lauderdale, Florida, with complaints of acute pain and swelling of the scrotum. Physical examination reveals an exquisitely tender, swollen right testis that is rather hard to examine. The cremasteric reflex is absent, but there is no swelling in the inguinal area. The rest of his genitourinary examination appears to be normal. A urine dip is negative for red and white blood cells. Which of the following is the appropriate next step in management?

  1. Administration of antibiotics after culture of urethra for chlamydia and gonorrhea
  2. Reassurance
  3. Intravenous fluid administration, pain medications, and straining of all voids
  4. Ultrasound of the scrotum
  5. Laproscopic exploration of both inguinal regions

the answer is below…

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