Clinical assessment and risk stratification

Typically, the patient will be in a significant amount of pain, however treatment still needs to follow the CABCDE principles for trauma. Particular attention should be paid to mechanism to ensure that other potential injuries are considered and accounted for.

Early analgesia is a must in these patients, and one should consider use of non-pharmacological relief such as support and ice packs as well as adjunct/on and opioid analgesia. Examination of the scrotum, whilst uncomfortable, is still necessary. Cremasteric spasm may result in an incarcerated testicle which is a urological emergency and can be identified by an empty hemi-scrotum.