GP Vivas · mens-health
Scrotal and testicular complaints — structured viva
Structured oral on scrotal and testicular complaints: TWIST-scored triage of the acute scrotum, Doppler accuracy and its limits, the salvage clock with manual detorsion, age-stratified epididymitis, the cancer lump pathway, benign lumps from varicocele to hydrocele, cryptorchidism risk, and Fournier's gangrene.
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Study tools
Target exams
RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'A 16-year-old wakes at 2 am with severe left testicular pain. His mother calls your after-hours line. Take me through it.' The viva branches through emergency triage, imaging rules, timing and salvage, the older male with scrotal pain, lumps that are cancer until proven otherwise, and benign lumps managed in general practice.
Stem
You are the GP on call. The clock started when the pain did — everything you advise either protects the testis or costs it. [7]
References11ShowHide
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- [3]Barbosa JABA, de Freitas PFS, Carvalho SAD et al. Validation of the TWIST score for testicular torsion in adults. International urology and nephrology, 2021.PMID 32844355
- [9]Alexander CE, Warren H, Light A et al. Ultrasound for the Diagnosis of Testicular Torsion: A Systematic Review and Meta-analysis of Diagnostic Accuracy. European urology focus, 2026.PMID 40368720
- [7]Seizilles de Mazancourt E, Khene Z, Sbizerra M et al. Cut-off time for surgery and prediction of orchiectomy in spermatic cord torsion: a retrospective multicentric study over 15 years. World journal of urology, 2023.PMID 37897515
- [11]Kılıç S Effectiveness of manual detorsion in the treatment of testicular torsion: systematic review and meta-analysis. The Canadian journal of urology, 2026.PMID 42415571
- [2]Taylor SN Epididymitis. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2015.PMID 26602616
- [5]Florou M, Tsilidis KK, Siomou E et al. Orchidopexy for congenital cryptorchidism in childhood and adolescence and testicular cancer in adults: an updated systematic review and meta-analysis of observational studies. European journal of pediatrics, 2023.PMID 36988678
- [6]Shakiba B, Heidari K, Afshar K et al. Aspiration and sclerotherapy versus hydrocelectomy for treating hydroceles: a systematic review and meta-analyses. Surgical endoscopy, 2023.PMID 37277518
- [1]Kolon TF Evaluation and Management of the Adolescent Varicocele. The Journal of urology, 2015.PMID 26119668
- [10]Ahmad F, Daryanto B, Purnomo AF High mortality and clinical characteristics of Fournier's gangrene: a 10-year retrospective study from an Indonesian tertiary hospital. Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica, 2026.PMID 42100832
- [8]Gerena M, Allen BC, Turkbey B, et al. ACR Appropriateness Criteria Acute Onset of Scrotal Pain-Without Trauma, Without Antecedent Mass: 2024 Update. Journal of the American College of Radiology : JACR, 2024.PMID 39488348