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Since being approved by the United States Food and Drug Administration (FDA) in 2013, sodium-glucose cotransporter-2 inhibitors (SGLT2is) have emerged as an appealing therapeutic choice for patients with diabetes due to their favorable effects on renal and cardiac health. Recent trials have further expanded the application of these drugs by showing a decrease in mortality rates among patients with both reduced and preserved ejection fraction heart failure, even in those without diabetes. Common adverse effects of SGLT2is include increased urinary frequency and urinary tract infections stemming from elevated glycosuria. Here, we present a case report involving a 66-year-old man who developed Fournier's gangrene (FG) shortly after initiating dapagliflozin - a rare but dangerous adverse effect associated with this medication., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Shaykh et al.)

Amiodarone is commonly used to prevent and treat life-threatening cardiac arrhythmias. However, it is also known to have an extensive side effect profile. A rare adverse effect of amiodarone is epididymitis. Epididymitis is inflammation of the epididymis that causes moderate pain in the posterior scrotum. The patient, in this case, developed left scrotal pain seven months after starting amiodarone and presented with symptoms consistent with epididymitis. The patient's work-up included urinalysis with culture, treatment with antibiotics, and testicular ultrasound before being diagnosed with amiodarone-induced epididymitis. This diagnosis led to the discontinuation of amiodarone, which resulted in the complete resolution of the patient's symptoms within two weeks. This case report is intended to increase awareness of epididymitis as a possible adverse effect of amiodarone and to stress the importance of considering this when there are no apparent anatomical or infectious causes of epididymitis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Lyon et al.)

Introduction: Testicular torsion is a time-sensitive surgical emergency. Assessment of the acute scrotum warrants rapid surgical review and low threshold for surgical intervention.  Materials and methods: A retrospective cohort study was undertaken for a three-month period during the first wave of the 2020 COVID-19 pandemic and the corresponding period in 2019. Data were collected for all scrotal explorations undertaken at our non-urological centre during this time., Results: Sixteen scrotal explorations were performed from April to June 2019, one had testicular torsion (6.25%). Forty-one explorations were performed from April to June 2020, nine had testicular torsion (21.95%). The most common diagnosis was epididymitis or epididymo-orchitis in 2019 and 2020 (27% and 37.5%, respectively). Sixty-two percent of patients presented within 12 hours in 2019 compared to only 37% during the first wave of the coronavirus disease 2019 (COVID-19) pandemic., Conclusion: This study found an increase in the number of patients presenting with acute scrotal pain triggering surgical intervention and the number of patients with testicular torsion. This is likely to reflect a decrease in patients able to access primary care assessment but may also be related to COVID-19. There was a marked delay in the presentation which has significant implications for testicular viability., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Davis et al.)

Background: Acute scrotal pain has many causes. According to the American Urological Association recommendations: history, physical examination, and ultrasound are key in diagnosing acute scrotal pain., Objective: The primary objective of this study was to evaluate the frequency of urinary tract infections (UTI) on routine Urinalysis (UA) in patients presenting with acute scrotal pain to the emergency department (ED)., Methods: We conducted a multicentered retrospective chart review of patients who presented to the ED with acute scrotal pain. Patient visits from February 1, 2018 to November 1, 2019 from 13 EDs were analyzed. Demographic data, UA interpretation, urine culture, gonorrhea and chlamydia (GC) testing, clinical findings, treatment outcomes, and ultrasounds were recorded. Patients who did not have a UA and scrotal ultrasound performed or who had a diagnosis of scrotal cellulitis or soft tissue infection were excluded., Results: There were 2,392 patients included in the study. A UTI was present in 173 (7.2%) patients. Of the patients who were found to have a UTI, 100/173 (57.8%) had a concomitant ultrasound diagnosis of epididymitis/orchitis. Also, 731 patients underwent GC testing in addition to standard UA collection, and ultrasound, seven were positive for gonorrhea (0.95%), and 30 were positive for chlamydia (4.10%)., Conclusions: Routine UA collection of patients presenting to the ED with acute scrotal pain should be considered, especially in patients with a concomitant ultrasound diagnosis of epididymo-orchitis. GC testing has limited yield without symptoms suggestive of sexually transmitted infections and a normal ultrasound., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Greenstein et al.)

Chronic scrotal pain (CSP) is a common and poorly understood medical condition that significantly affects individuals' quality of life. Many patients seek evaluation and management of their symptoms from multiple physicians. Our review aims to address diagnostic modalities, clinical evaluation, and surgical and non-surgical management. We conducted a computerised detailed search of the PubMed, Medline, Embase and Cochrane databases for reports pertaining to CSP using the Medical Subject Headings keywords 'chronic scrotal pain', 'testicular pain' and 'orchialgia', and we included in the review those that fulfilled the inclusion (adult male with CSP presenting with the criteria of CSP ) and exclusion (extra-scrotal pain) criteria. After the direct causes of CSP were identified by reviewing the clinical evaluations (history taking and examination are mandatory) and the diagnostic evaluations (urine analysis is crucial and ultrasound can be helpful), the most-used medical and non-surgical treatments for CSP were tricyclic antidepressants (success rate of up to 66.6%) and spermatic block (success rate of more than 90%), and the most-used surgical procedure was microsurgical denervation of the spermatic cord (success rate of up to 70%). The evidence currently available remains rare and of low quality, making it difficult to strongly recommend individual treatment options. However, multimodal treatment modalities using physical therapy and psychotherapy may help patients and provide useful tools for coping with this condition. There are also useful non-surgical and surgical options for CSP that depend on the patient's state, the severity of the complaint and what options have already been tried., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Moubasher et al.)