[Decision-making regarding the acute scrotum]

An account is given of results obtained from aggressive decisions taken to cope with acute scrotal pain. Thirteen in 121 patients received surgical treatment, although this would have been avoidable, since only epididymitis was eventually detected. That rate, however, had to be accepted due to inadequate reliability of the diagnostic methods so far available, even more so, when the following results are considered: The organ was saved in 39 cases. Pain was removed from 15 cases with pedunculated hydatid. Ten haematomas resulting from blunt testicular trauma were emptied. The surgical approach may be considered suitable for diagnosis, since complications are not to be expected, with the average time of the operation being limited to 18 minutes. The following guideline, therefore, should be observed in cases of post-traumatic, acute testicular pain: Diagnostic exposure is the optional method in cases of even slightest doubt in epididymitis. A sceptical attitude seems to be appropriate for all age groups, particularly when young patients are involved. Surgical exploration is a no-risk and fast approach and the only dependable method to save the organ.