03-25-2009, 08:34 PM
A 38-year-old man comes to the office and complains of right testicular pain. For the past week, he has had dysuria, which is improving. The patient has no other medical problems. He is currently not taking any medications. He denies the use of tobacco, alcohol or illicit drugs. He occasionally has unprotected sex with prostitutes, and had gonococcal urethritis 6 years ago. Examination reveals tenderness on palpation of the right testicle, with an apparent increase in size, and a soft, small (2 x 2 cm), but very tender mass adjacent to it. There is no urethral discharge. Which of the following will be the most appropriate next step in the management of this patient?
A.
Immediate referral to the urologist
B.
Order a testicular sonogram.
C.
Start oral ciprofloxacin.
D.
Start ibuprofen.
E.
Perform transillumination of the testicles.
A.
Immediate referral to the urologist
B.
Order a testicular sonogram.
C.
Start oral ciprofloxacin.
D.
Start ibuprofen.
E.
Perform transillumination of the testicles.