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Acute Swelling and Pain in Scrotal Region
ACUTE SWELLING AND PAIN IN SCROTAL REGION
Dr. Vivek M. Rege
Pediatric Surgeon & Pediatric Urologist
B J Wadia Hospital For Children, Hurkisondas Hospital, Wockhardt Hospital, Mumbai


This is one condition that requires a quick decision and urgent surgery.
Acute Swelling and Pain in Scrotal Region The usual story is that of a boy who comes home from school or from playing with a pain in the scrotal region. The onset may have been while the boy was playing or even more often while sitting. There may be some history of trauma, which may lead to the parents to assume that pain is due to Normal Structure of Testis direct trauma only. However, the boy must be thoroughly questioned to find out when did the pain actually start, has it remained the same, increased, or decreased and disappeared. Check if the boy is having any urinary problem like burning or painful micturition prior to the pain. Also, one must check for swelling and redness on one side of the scrotum. Thus a boy presenting with pain and swelling on one side of the scrotum has to be given immediate therapy since there are 2 possibilities. The first is Testicular torsion that requires urgent surgery to untwist the torsion; the other is epididymo orchitis that requires purely non surgical therapy.
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Difficulty in Passing Urine
Difficulty in Passing Urine
Difficulty in Passing Urine
The parents in younger children may notice this or the older ones may be able to vocalize and tell their parents. The boy may be straining to pass urine, have a thin stream of urine, which may fall close to his feet. The child may cry when passing urine, may pull at the penile skin after passing urine, or have a habit of rubbing the penile tip skin off and on.

During the course of the day the parents may notice that the child continuously has his hand on his penis. All these are signs of irritation, infection, inflammation of the prepucial skin, which is long standing. The parent may notice a ballooning of the prepucial skin before the urine stream comes out.
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