The most common cause of acute scrotal pain is epididymitis.[6]American College of Radiology. ACR appropriateness criteria: acute onset of scrotal pain - without trauma, without antecedent mass. 2014 (revised 2018) [internet publication].
https://acsearch.acr.org/docs/69363/Narrative/
North American and European data on the incidence and prevalence of acute epididymitis are limited, as the condition is not subject to national surveillance. In the US, there are approximately 600,000 cases of epididymitis reported each year.[7]Trojian TH, Lishnak TS, Heiman D. Epididymitis and orchitis: an overview. Am Fam Physician. 2009 Apr 1;79(7):583-7.
http://www.ncbi.nlm.nih.gov/pubmed/19378875?tool=bestpractice.com
[8]Lorenzo L, Rogel R, Sanchez-Gonzalez JV, et al. Evaluation of adult acute scrotum in the emergency room: clinical characteristics, diagnosis, management, and costs. Urology. 2016 Aug;94:36-41.
http://www.ncbi.nlm.nih.gov/pubmed/27210570?tool=bestpractice.com
One 2005 study in Canada showed that 0.9% of men seen at an outpatient practice over a 2.5-year period presented with epididymitis.[9]Nickel JC, Teichman JM, Gregoire M, et al. Prevalence, diagnosis, characterization, and treatment of prostatitis, interstitial cystitis, and epididymitis in outpatient urological practice: the Canadian PIE Study. Urology. 2005 Nov;66(5):935-40.
http://www.ncbi.nlm.nih.gov/pubmed/16286098?tool=bestpractice.com
In the UK, the reported incidence was 2.45 cases per 1000 men between 2003 and 2008.[10]Nicholson A, Rait G, Murray-Thomas T, et al. Management of epididymo-orchitis in primary care: results from a large UK primary care database. Br J Gen Pract. 2010 Oct;60(579):e407-22.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2944950/
http://www.ncbi.nlm.nih.gov/pubmed/20883615?tool=bestpractice.com
Another study, undertaken in Europe, estimated the incidence of epididymitis at 1.2 per 1000 male children.[11]Somekh E, Gorenstein A, Serour F. Acute epididymitis in boys: evidence of a post-infectious etiology. J Urol. 2004 Jan;171(1):391-4.
http://www.ncbi.nlm.nih.gov/pubmed/14665940?tool=bestpractice.com
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