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Prehn's sign is an evaluation used to determine the cause of testicular pain If testicular pain improves with elevation of the testicle, this is a positive prehn sign, which is associated with an increased risk of acute epididymitis. It is performed by lifting the scrotum and assessing the consequent changes in pain.
Positive prehn's sign indicates there is pain relief with lifting the affected testicle, which points towards epididymitis Scrotal elevation relieves pain in epididymitis but not torsion Another way to differentiate between epididymitis and torsion on physical examination is checking for the cremaster reflex which is classically absent in the case of torsion.
Prehn sign is used to differentiate bacterial epididymitis and testicular torsion (scrotal elevation relieves pain in epididymitis but not torsion).
Prehn sign refers to the relief of testicular pain when the scrotum is elevated The interpretation of this physical examination finding is critical in differentiating between various causes of acute scrotal pain: Prehn’s sign is used to help differentiate the etiology of the acute scrotal pain The maneuver is performed simply by elevating the suspected testis in the scrotum, determining if the patient’s pain worsens or improves.
This video provides an overview of how to perform prehn's test to elicit prehn's sign in the context of testicular pain when testicular torsion is suspected. Relief of pain with elevation of testes (suggestive of epididymitis but may be positive with testicular torsion as well) hernia exam Use your index finger to invaginate the scrotal skin adjacent to the external inguinal ring and direct your finger up toward the pubic tubercle. Prehn’s sign is the alleviation of scrotal pain by lifting of the testicle and is suggestive of the diagnosis of acute epididymitis
It has a sensitivity of 91% and specificity of 78%.
Prehn's sign is used to discriminate between bacterial epididymitis and testicular torsion
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