title: Use of ultrasound and surgery in adults with acute scrotal pain.
abstract: BACKGROUND
  The epidemiology of patients with acute scrotal pain presenting to the emergency department (ED) is largely unknown. Urgent surgical referral is recommended for patients presenting with suspected testicular torsion. However, we have noted an increasing use of Doppler ultrasound (US) as an adjunctive tool in the evaluation of patients with acute scrotal pain. This study aimed to retrospectively review the presentation of patients with acute scrotal pain to a tertiary ED and the use of ultrasound in the assessment of acute scrotal pain.
  
  
  METHODS
  An explicit chart review was performed including all patients presenting to an adult tertiary ED between 2003 and 2008 with acute scrotal pain. The timing of presentation, initial assessment, review by the Urology team and the use of US were recorded. The diagnosis recorded at hospital discharge was the primary end point, while follow-up at outpatient clinic or private urologist rooms was used as a secondary end point.
  
  
  RESULTS
  There were 329 patients with acute scrotal pain during the study period, with 294 patients included in the study. Of these, 173 (58.8%) had a US scan performed in the ED. There were 44 (15.0%) patients who underwent scrotal exploration, with 19 having a prior US. There was a significant increase in the use of US over the study period.
  
  
  CONCLUSIONS
  Colour-flow duplex Doppler ultrasonography appeared to play an increasing role in the assessment for patients presenting with acute testicular pain. Rapid and more reliable assessments of these patients may be possible through greater education of emergency personnel in ultrasonography techniques.
authors.affiliation: Emergency & Trauma Centre, Monash University, Melbourne, Victoria, Australia.
authors.forename: Ashish
authors.initials: A
authors.lastname: Jaison
authors.forename: Biswadev
authors.initials: B
authors.lastname: Mitra
authors.forename: Peter
authors.initials: P
authors.lastname: Cameron
authors.forename: Shomik
authors.initials: S
authors.lastname: Sengupta
mesh_terms: D000208:Acute Disease; D000328:Adult; D057210:Delayed Diagnosis / Q000517:prevention & control*; D003937:Diagnosis, Differential; D004630:Emergencies; D005832:Genital Diseases, Male / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D008297:Male; D010146:Pain / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D013086:Spermatic Cord Torsion / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D018615:Ultrasonography, Doppler, Color / Q000706:statistics & numerical data*; D014739:Victoria / Q000453:epidemiology