Clinical characteristics and management of patients presenting with scrotal complaint in the emergency department

Clinical Characteristics and Management of Patients Presenting with Scrotal Complaint in the Emergency Department Objective: This is a retrospective cohort study aiming to reveal the clinical characteristics of patients presenting to the emergency department with scrotal complaints. Method: We analyzed the data of patients who presented to the emergency department of a tertiary care hospital with scrotal complaints and underwent ultrasonographic evaluation over a 5-year period. The complaints and duration of presentation, presence of trauma, USG results, examination results, treatments and outcomes were recorded. Findings: Out of a total of 873 patients, 150 patients were excluded due to lack of data. Of the 723 patients included, the median age was 25 years (IQR 15-39) and 482 (66.7%) were 18 years of age or older. The most common presenting complaint was scrotal pain in all age groups (n=717 and 99.2%). The number of patients presented after trauma was 47 (6.5%) and was more common in patients under 18 years of age. In this age group, complete blood count and consultation were requested more frequently (p=0.011 and p<0.001, respectively) and analgesia was administered less frequently (p=0.029). The median value for the duration of complaint was 24 hours (IQR 8-48) in the group presenting with pain, 10 hours (IQR 2-48) in the trauma group, and 12 hours (IQR 2-48) in those diagnosed with torsion. The median time to reach the USG result in the emergency department was 25.0 min (IQR 16-40). The most common sonographic pathology was isolated epididymitis (n=135, 18.7%). There was a statistically significant correlation between elevated CRP (p<0.001) and pyuria (p=0.001) in patients with sonographic diagnosis of epididymitis, epididymorchitis and isolated orchitis (n=63, 30.3%). The number of patients with surgical consultation was 158 (21.9%), and 38 (5.3%) of 53 (7.3%) patients who were hospitalized underwent emergency surgery. 39 Conclusion: Scrotal complaints, which can be the cause of presentation in all age groups, are an important cause of morbidity that can be managed mostly in the emergency department with clinical and sonographic evaluation and often do not require additional investigations.