title: Evaluation of Adult Acute Scrotum in the Emergency Room: Clinical Characteristics, Diagnosis, Management, and Costs.
abstract: OBJECTIVE
  To evaluate the clinic characteristics, diagnosis, management, and costs of the adult acute scrotum in the emergency room (ER). Acute scrotum is a syndrome characterized by intense, acute scrotal pain that may be accompanied by other symptoms. It is usual in children and commonly found as well in adults, with different causal pathologies between these groups.
  
  
  METHODS
  Between November 2013 and September 2014, 669 cases of adult acute scrotum who presented to our ER were prospectively analyzed. Patients under 15 years of age were excluded. Patient age, reason for consultation, investigations performed, final diagnosis, management, and costs were evaluated. For the statistical analysis, the Mann-Whitney, Kruskal-Wallis U, and chi-square tests were used.
  
  
  RESULTS
  A total of 669 cases of acute scrotum were analyzed. The mean age at presentation was 40.2 ± 17.3 years. The most presented diagnoses were orchiepididymitis (28.7%), epididymitis (28.4%), symptoms of uncertain etiology (25.1%), and orchitis (10.3%). Diagnostic tests were carried out in 57.8% of cases. Most cases were treated as outpatients (94.2%), with 5.83% admitted and 1% undergoing surgical treatment. Overall, 13.3% of patients represented to the ER. Abnormal results in blood and urine tests were more common among older patients and infectious pathologies. The average cost generated by an acute scrotum ER consult was 195.03€.
  
  
  CONCLUSIONS
  Infectious pathologies are the most common causes of acute scrotum at ER. Abnormal blood and urine tests are unusual and are more common in older patients and infectious pathologies.
authors.affiliation: Department of Urology, University and Polytechnic Hospital La Fe, Valencia, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Lorenzo
authors.affiliation: Department of Urology, University and Polytechnic Hospital La Fe, Valencia, Spain. Electronic address: ramonrogelberto@hotmail.com.
authors.forename: Ramon
authors.initials: R
authors.lastname: Rogel
authors.affiliation: Department of Urology, University and Polytechnic Hospital La Fe, Valencia, Spain.
authors.forename: Jose V
authors.initials: JV
authors.lastname: Sanchez-Gonzalez
authors.affiliation: Department of Urology, University and Polytechnic Hospital La Fe, Valencia, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Perez-Ardavin
authors.affiliation: Department of Biological Statistics, Instituto de Investigaciones Sanitarias La Fe, Valencia, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Moreno
authors.affiliation: Department of Urology, University and Polytechnic Hospital La Fe, Valencia, Spain.
authors.forename: Saturnino
authors.initials: S
authors.lastname: Lujan
authors.affiliation: Department of Urology, University and Polytechnic Hospital La Fe, Valencia, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Broseta
authors.affiliation: Department of Urology, University and Polytechnic Hospital La Fe, Valencia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Boronat
mesh_terms: D059787:Acute Pain / Q000175:diagnosis / Q000191:economics / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004630:Emergencies; D004636:Emergency Service, Hospital; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012611:Scrotum; D055815:Young Adult