A 45-year-old male presents with acute scrotal pain and swelling that started after sexual intercourse. The patient also feels nauseated. What could be the potential causes and what are the next steps?
Sudden onset of scrotal pain and swelling after intercourse could indicate testicular torsion, where the spermatic cord becomes twisted, cutting off the testicle's blood supply. Epididymitis or orchitis could also present similarly. This condition is a urologic emergency and requires immediate evaluation, which usually includes a physical examination, urinalysis, and scrotal ultrasound.