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학습 자료 둘러보기 →Epididymitis presents with a gradual onset of unilateral pain, often peaking over days. Pain is typically exacerbated by walking or movement due to the weight of the inflamed epididymis. A positive Prehn's sign (pain relief with scrotal elevation) may be present but is not definitive.
In contrast, testicular torsion causes a sudden onset of severe, constant pain, often waking the patient from sleep. It is frequently accompanied by nausea and vomiting. The affected testis may have a high-riding, horizontal lie and an absent cremasteric reflex.
Do not rely solely on Prehn's sign or urinalysis to rule out torsion. Any case of acute scrotal pain with a sudden onset in an adolescent or young male is a surgical emergency until proven otherwise. Immediate urology consultation and Doppler ultrasound are critical to avoid testicular loss within 4-8 hours.
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