The role of a urine dipstick in the diagnosis of the acute scrotum
Abstract Objective To evaluate the role of a urine dipstick in the assessment of acute scrotal pain emergency department presentations. Methods A single institution, prospective case series, from February 2020 to February 2021. All patients who received a bedside review by a urology doctor for acute...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-07-01
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| Series: | BJUI Compass |
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| Online Access: | https://doi.org/10.1002/bco2.138 |
| _version_ | 1811333962263429120 |
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| author | Sophie Tissot Christopher Perrott Richard Grills |
| author_facet | Sophie Tissot Christopher Perrott Richard Grills |
| author_sort | Sophie Tissot |
| collection | DOAJ |
| description | Abstract Objective To evaluate the role of a urine dipstick in the assessment of acute scrotal pain emergency department presentations. Methods A single institution, prospective case series, from February 2020 to February 2021. All patients who received a bedside review by a urology doctor for acute scrotal pain were included. Urine dipstick results were pre‐defined as having had an impact on the emergency clinician's diagnosis if it showed pyuria and/or nitrituria and the final diagnosis was epididymitis‐orchitis or haematuria and the final diagnosis was ureterolithiasis. Results 139 patients presented to the emergency department with a complaint of acute scrotal pain. 85 (61%) were referred for bedside urology review. Median age of 17 years (P25 12 yrs, P75 31 yrs). 2.3% (n = 2) had proven testicular torsion, 28.5% (n = 24) had epididymitis‐orchitis and 8.2% (n = 7) had ureterolithiasis. 68 (80%) of patients received a primary diagnosis of testicular torsion by the emergency department clinician. Following review by a urology unit doctor, 14 proceeded to scrotal exploration for concern of testicular torsion. 7 patients were diagnosed with ureterolithiasis, all of whom had haematuria on their urine dipsticks (100%, 95% CI: 59–100%), 100% of these urine dipsticks were initiated by the urology unit doctor following bedside review. 22 patients were diagnosed with epididymitis‐orchitis. 8 of these had pyuria, nitrituria and/or haematuria on their urine dipstick (36%, 95% CI: 17–59%) and only one urine dipstick was completed prior to referral. 20.6% of patients perceived to have testicular torsion by the emergency department had a positive urine dipstick that aligned with their final alternative diagnosis (95% CI: 12–32%). Conclusion A collection of clinical findings is required to diagnose the aetiology of acute scrotal pain. Information that can be easily, quickly, cheaply, and reliably collected, such as a urine dipstick, can assist in clinical decision making. |
| first_indexed | 2024-04-13T17:00:37Z |
| format | Article |
| id | doaj.art-b720ff1fb1e94fcf8974f3dba79e506a |
| institution | Directory Open Access Journal |
| issn | 2688-4526 |
| language | English |
| last_indexed | 2024-04-13T17:00:37Z |
| publishDate | 2022-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | BJUI Compass |
| spelling | doaj.art-b720ff1fb1e94fcf8974f3dba79e506a2022-12-22T02:38:41ZengWileyBJUI Compass2688-45262022-07-013428729010.1002/bco2.138The role of a urine dipstick in the diagnosis of the acute scrotumSophie Tissot0Christopher Perrott1Richard Grills2Department of Urological Surgery, Barwon Health University Hospital Geelong Geelong AustraliaDepartment of Urological Surgery, Barwon Health University Hospital Geelong Geelong AustraliaDepartment of Urological Surgery, Barwon Health University Hospital Geelong Geelong AustraliaAbstract Objective To evaluate the role of a urine dipstick in the assessment of acute scrotal pain emergency department presentations. Methods A single institution, prospective case series, from February 2020 to February 2021. All patients who received a bedside review by a urology doctor for acute scrotal pain were included. Urine dipstick results were pre‐defined as having had an impact on the emergency clinician's diagnosis if it showed pyuria and/or nitrituria and the final diagnosis was epididymitis‐orchitis or haematuria and the final diagnosis was ureterolithiasis. Results 139 patients presented to the emergency department with a complaint of acute scrotal pain. 85 (61%) were referred for bedside urology review. Median age of 17 years (P25 12 yrs, P75 31 yrs). 2.3% (n = 2) had proven testicular torsion, 28.5% (n = 24) had epididymitis‐orchitis and 8.2% (n = 7) had ureterolithiasis. 68 (80%) of patients received a primary diagnosis of testicular torsion by the emergency department clinician. Following review by a urology unit doctor, 14 proceeded to scrotal exploration for concern of testicular torsion. 7 patients were diagnosed with ureterolithiasis, all of whom had haematuria on their urine dipsticks (100%, 95% CI: 59–100%), 100% of these urine dipsticks were initiated by the urology unit doctor following bedside review. 22 patients were diagnosed with epididymitis‐orchitis. 8 of these had pyuria, nitrituria and/or haematuria on their urine dipstick (36%, 95% CI: 17–59%) and only one urine dipstick was completed prior to referral. 20.6% of patients perceived to have testicular torsion by the emergency department had a positive urine dipstick that aligned with their final alternative diagnosis (95% CI: 12–32%). Conclusion A collection of clinical findings is required to diagnose the aetiology of acute scrotal pain. Information that can be easily, quickly, cheaply, and reliably collected, such as a urine dipstick, can assist in clinical decision making.https://doi.org/10.1002/bco2.138diagnosisdipstickhaematuriapyuriascrotumtorsion |
| spellingShingle | Sophie Tissot Christopher Perrott Richard Grills The role of a urine dipstick in the diagnosis of the acute scrotum BJUI Compass diagnosis dipstick haematuria pyuria scrotum torsion |
| title | The role of a urine dipstick in the diagnosis of the acute scrotum |
| title_full | The role of a urine dipstick in the diagnosis of the acute scrotum |
| title_fullStr | The role of a urine dipstick in the diagnosis of the acute scrotum |
| title_full_unstemmed | The role of a urine dipstick in the diagnosis of the acute scrotum |
| title_short | The role of a urine dipstick in the diagnosis of the acute scrotum |
| title_sort | role of a urine dipstick in the diagnosis of the acute scrotum |
| topic | diagnosis dipstick haematuria pyuria scrotum torsion |
| url | https://doi.org/10.1002/bco2.138 |
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