Prehn’s sign – Knowledge and References

Prehn's sign

Testicular torsion

Published in J Kellogg Parsons, E James Wright, The Brady Urology Manual, 2019

Physical examination: Tender, high-riding testis (secondary to foreshortening of the spermatic cord as a result of twisting) with an abnormal, transverse lieMay have associated hydrocele and/or scrotal edemaAbsence of a cremasteric reflex (i.e. stroking the ipsilateral medial thigh fails to produce contraction of the affected testicle)Unlike epididymitis, elevation of the scrotum will not relieve the pain (negative Prehn’s sign)‘Blue dot sign’ is a small, dark blue spot on the skin that may occur with torsion of a testicular appendage (appendix testis or epididymis) but not testicular torsion.

Gonococcal epididymo-orchitis in an octogenarian

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Journal Information

Published in Journal of Community Hospital Internal Medicine Perspectives, 2020

Ali Ahmad, Halina Kusz

Acute EO secondary to Neisseria gonorrhea is an uncommon finding in the geriatric population. The presence of scrotal pain, tenderness, and edema is suggestive of the diagnosis. Symptoms may also include fever, dysuria, hematuria, and urinary frequency[1]. Findings on physical examination include tenderness and swelling of the epididymitis and scrotum. Prehn’s sign may also be positive, which is suggested by improvement in pain with elevation of the testicles. Older adults, in particular, can manifest severe systemic illness such as septic shock seen in this patient. Predisposing factors include urinary tract infections, sexually transmitted infections, prostate or urinary tract surgeries or instrumentation, urinary tract outflow obstruction, and trauma [1].

Prehn's sign

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Testicular torsion

Gonococcal epididymo-orchitis in an octogenarian