Prehn's sign

The change in acute scrotal pain with elevation of the affected testis, reflecting the influence of mechanical support on scrotal discomfort. Pain relief with elevation suggests an inflammatory process, whereas persistent pain despite elevation raises concern for spermatic cord torsion.

Associated conditions

• Positive elevation response (pain relief)

  • Epididymitis

  • Epididymo-orchitis

  • Orchitis

  • Inflammatory scrotal conditions

  • Scrotal edema associated with infection or inflammation

• Negative elevation response (no pain relief)

  • Testicular torsion

  • Torsion of the testicular appendage

  • Spermatic cord torsion causing testicular ischemia

• Other causes of acute scrotal pain

  • Inguinal hernia

  • Trauma

  • Hydrocele with acute inflammation

  • Varicocele-related discomfort

  • Scrotal abscess

  • Testicular tumor with hemorrhage or necrosis