Prehn sign is positive in which condition?

• A. Epididymo-orchitis
• B. Orchitis
• C. Prostatitis
• D. Testicular torsion

Answer: (A)

The main idea tested is how the Prehn sign helps distinguish types of acute scrotal pain. This sign is positive when lifting the scrotum relieves the pain, which is most characteristic of epididymo-orchitis. In inflammatory swelling of the epididymis and testis, elevating the scrotum improves venous drainage and reduces edema and pressure, leading to less pain. In contrast, testicular torsion causes pain from twisting and ischemia, and elevation does not relieve it, so the sign is negative. Prostatitis involves the prostate and typically doesn’t present with scrotal pain that improves with elevation, so the sign isn’t a reliable indicator there. Today, Doppler ultrasound is used to assess blood flow and help confirm the diagnosis, but the historical teaching remains: a positive Prehn sign points toward epididymo-orchitis.