Prehn's sign

Last edited 09/2022 and last reviewed 09/2022

Prehn's sign is used to discriminate between bacterial epididymitis and testicular torsion. Scrotal elevation relieves pain in epididymitis but not torsion.

Study evidence showed (1):

  • in multivariate analysis, a positive Prehn’s sign was predictive of testicular torsion, whereas fever, dysuria, high leucocyte counts in blood and/or urine, high blood C-reactive protein, and burning pain were predictive of genital/paragenital infection
  • 33% of patients with testicular torsion had a positive Prehn's sign at presentation

Reference:

  • Roth B, Giannakis I, Ricklin ME, Thalmann GN, Exadaktylos AK. An Accurate Diagnostic Pathway Helps to Correctly Distinguish Between the Possible Causes of Acute Scrotum. Oman Med J. 2018 Jan;33(1):55-60.