ABSTRACT
Acute scrotal pathology constitutes one of the few real emergencies in paediatric urology because of the risk to the testis posed by testicular torsion. A negative exploration is preferable to the loss of a potentially viable testis because of the failure to explore the scrotum. In the majority of cases, the testis twists within its coverings in the scrotum. Clinical examination may reveal that the affected testis is located in an elevated position within the scrotum as a consequence of contraction of the cremasteric muscle. Examination may reveal tenderness localised to an indurated nodule but tenderness is often more generalised and accompanied by thickening and erythema of the hemi scrotum. The clinical picture is characterised by marked oedema of the scrotum, which may be unilateral or may affect the entire scrotum – sometimes extending upwards to involve the subcutaneous tissues of the inguinal region.
