The issue of acute testicular pain is further complicated by the high potential for litigation associated with infertility after testicular loss due to torsion or disruption of the testicle from severe trauma. 2 However, the evaluation of acute testicular pain presents a considerable challenge for emergency providers, since 50% of patients presenting with testicular torsion have delayed seeking care for >6 hours and are at high risk of losing the torsed testicle. 2 This misconception has been dispelled and it is now known that the most common etiology of acute testicular pain is epididymitis. The traditional teaching was that most patients presenting to an ED or urgent care with a complaint of acute testicular pain had testicular torsion. 1 Causes of acute testicular pain include trauma, epididymitis, orchitis, torsion of the testicular appendage, and hernia however, testicular torsion is the diagnosis of the greatest concern in the emergency setting. Acute testicular pain represents about 0.5% of ED complaints.
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