Differential Diagnostic Factors in Acute Scrotal Pathologies: A Critical Analysis Focusing on the Visual Analog Scale

Objective: To investigate the relationship between the differential diagnosis of scrotal pathologies and inflammatory and clinical parameters.

Methods: The data of 228 patients who presented between January 2023 and September 2024 with scrotal pain to 2 urology clinics were retrospectively analyzed. The patients were examined in 4 groups: epididymo-orchitis, testicular torsion, testicular tumors, and non-acute scrotal pathologies. In addition to the patients’ demographic characteristics, physical examination findings, and complete blood count, Visual Analogue Scale (VAS) scores were also recorded to measure the severity of pain.

Results: In the multivariate analysis, age, VAS score, white blood cell count, neutrophil count, monocyte count, neutrophil/lymphocyte ratio, and complaint duration were statistically significant parameters. Multivariate post hoc analysis revealed that age was statistically significantly different in the torsion group compared to the epididymo-orchitis and non-acute scrotal pathology group. The VAS score was statistically significantly different in the torsion group compared to the epididymo-orchitis, tumor, and non-acute scrotal pathology groups. Complaint duration at presentation was statistically significantly different in the non-acute scrotal pathology group compared to the torsion group, in the tumor group compared to the torsion group, and in the epididymo-orchitis group compared to the torsion group.

Conclusion: Complaint duration at presentation was found to be shorter in patients with testicular torsion because the VAS score was higher than in the other groups.

Cite this article as: Üstün F, Bülbül E, Karaca Y. Differential diagnostic factors in acute scrotal pathologies: A critical analysis focusing on the visual analog scale. Cerrahpaşa Med J 2026, 50, 0102, doi: 10.5152/cjm.2026.25102.