Prehn sign

The Prehn's sign is a differential diagnostic sign for differentiating the acute scrotum . It can be used to differentiate between testicular torsion and inflammation of the epididymis ( epididymitis ) or the testicles ( orchitis ). In the classic case, testicular pain is reduced in epididymitis and orchitis by lifting the painful scrotum. In contrast, there is no decrease in pain in the presence of testicular torsion, and the pain may increase. This procedure was described by the American urologist DT Prehn in the 20th century.

The Prehn's sign is not conclusive, so that further diagnostic measures are usually necessary ( Doppler sonography ). After about four to six hours, the result of the examination is no longer so clear because of the incipient necrosis. Due to the narrow time window (loss of organs within about six hours), the testicle is surgically exposed in unclear cases.

execution

The examiner lifts the affected testicle.

• The pain decreases when the scrotum is raised: the Prehn's sign is positive , which indicates orchitis or epididymitis .
• The pain increases or remains unchanged when the scrotum is raised: The Prehn's sign is negative . This is e.g. B. the case with testicular torsion .

literature

• DT Prehn: A new sign in the differential diagnosis between torsion of the spermatic cord and epididymitis. In: J Urol . 32, 1934, p. 191.
• J. Sökeland, H. Schulze, H. Rübben: Urology: understand - learn - apply. 13th edition. Thieme, 2004, ISBN 3-13-300613-4 .
• Prehn's sign supports the diagnosis of testicular torsion. on aerztezeitung.de, April 21, 2004.

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !