Non-traumatic Scrotal/Testicular Pain Clinical Pathway — Emergency Department

History and Physical
History	Onset of symptoms Similar symptoms in the past Location, radiation, severity of pain Trauma Nausea, vomiting, abdominal pain Fever, dysuria Penile discharge, STIs, sexual history Analgesia, last dose Last PO intake
Physical Exam	VS Abdominal, flank tenderness Tanner staging Erythema, swelling, induration of scrotum Testicle lie, size, consistency Location of pain (corpus, posterior, superior, other) Cremasteric reflex Inguinal canal mass, reducibility Urethral discharge Prehn's sign – decreased pain with elevation of testis Rash Other signs of infectious disease Other evidence of trauma

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

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