A RARE CAUSE OF ACUTE SCROTAL PAIN IN PAEDIATRIC PATIENTS; A QUESTIONNAIRE SURVEY AND LITERATURE REVIEW

Background: Acute scrotal pain (ASP) in children is a urological emergency, which usually warrants scrotal exploration. In the paediatric population, Henoch Schonlen Purpura (HSP) can occasionally present with acute scrotal pain and oedema, which may be misdiagnosed with testicular torsion. We presented two cases encountered in our own practice; we also reviewed the literature and assessed awareness of the link between HSP and ASP amongst urologists. Subject and Methods: A questionnaire consisting of 9 questions was sent to 105 randomly selected urologists practicing in nine different countries including the UK. All of the urologists were currently employed in institutes accredited for training. Results: Response rate was 62% with 65 completed returns from urologist of previous levels. Only 25 (38%) were previously aware of the HSP-ASP relationship. In those who were aware of the HSP-ASP link, (28%) would still favour immediate scrotal exploration; while the remainder would perform a Doppler ultrasound scan before deciding. Overall, 91% felt that the HSP-ASP relationship was not well known and 82% considered this an important issue that the practicing urologist should be aware of. Conclusions: Despite variations in practice with regards to the management of ASP, the relationship between HSP and ASP is not well known. Though the mainstay of the management of patients with ASP is immediate scrotal exploration, we consider that practicing urologists need to be made aware of the link between HSP and ASP. Duhok Med J 2017; 11 (2): 59-66.