Question

A 26-year-old man presents with sudden onset severe left testicular pain of 2 hours' duration. The left testis is high-riding and very tender, with an absent cremasteric reflex. There is no dysuria or urethral discharge. What is the most appropriate next step?

Accepted Answer

Urgent urological consultation for suspected testicular torsion and immediate surgical exploration

Answer

Empiric antibiotics for presumed epididymo-orchitis with outpatient follow-up

Answer

Scrotal ultrasound only and await results before any further action, regardless of delay

Answer

Reassure the patient and observe because symptoms are likely self-limiting

Answer

Prescribe analgesia and advise follow-up in 48 hours

Practice question

A 26-year-old man presents with sudden onset severe left testicular pain of 2 hours' duration. The left testis is high-riding and very tender, with an absent cremasteric reflex. There is no dysuria or urethral discharge. What is the most appropriate next step?