Urology · Model history
Sudden severe testicular pain: a model urology history
- Setting
- Emergency department
- Patient
- Mr. Adams, 16, woke with sudden, severe right testicular pain two hours ago.
- Listen
- 3 min
After listening
Say the next question
Read the patient’s answer, say your next question aloud, then reveal the model.
“Yes, I've thrown up twice since it started.”
Ask one question that tests whether elevating the scrotum relieves the pain (Prehn sign).
If I gently lifted your scrotum, do you think that would ease the pain, or would it stay just as bad?
Model interview
Full transcript
- Doctor
I'm Dr. Hayes. I understand you're in a lot of pain. Tell me what happened.
- Patient
I woke up around four this morning with this sudden, awful pain in my right testicle. It hasn't let up since.
- Doctor
Did it start suddenly, or did it build up slowly?
- Patient
It came on suddenly, out of nowhere, while I was asleep.
- Doctor
Does the pain stay in your testicle, or does it spread anywhere else?
- Patient
It spreads up into my lower belly and my right groin.
- Doctor
On a scale of zero to ten, how bad is it right now?
- Patient
It's about a nine. It's the worst pain I've ever had.
- Doctor
Have you felt sick to your stomach or thrown up?
- Patient
Yes, I've thrown up twice since it started.
- Doctor
If I gently lifted your scrotum, do you think that would ease the pain, or would it stay just as bad?
- Patient
I don't think lifting it would help at all. It just hurts no matter what.
- Doctor
Did you get hit in the groin, or were you playing sports before this started?
- Patient
No, nothing like that. I was just sleeping.
- Doctor
Have you had any burning when you urinate, or any discharge?
- Patient
No, nothing like that.
- Doctor
Have you had a fever?
- Patient
No, I don't think so.
- Doctor
Have you ever had pain like this before, even if it went away on its own?
- Patient
No, never anything like this.
- Doctor
Do you have any other medical conditions, or take any regular medicines?
- Patient
No, I've always been healthy.
- Doctor
Any medicine allergies?
- Patient
No, not that I know of.
- Doctor
What do you think is happening?
- Patient
I'm scared my testicle is dying. It hurts so much I think something's really wrong.
- Doctor
What's worrying you most?
- Patient
I'm terrified I could lose it, and that it might affect me having kids someday.
- Doctor
What were you hoping we could do for you today?
- Patient
I want something for the pain right now, and if I need surgery to save it, I want that done as soon as possible.
- Doctor
Let me make sure I understand. Two hours ago you woke suddenly with severe right testicular pain spreading into your groin, with two episodes of vomiting. Lifting the scrotum doesn't relieve it, there's no history of trauma, fever, burning with urination, or discharge, and you've never had pain like this before. Is that accurate, and is there anything else?
- Patient
That's exactly right. Nothing else.
- Doctor
Thank you for telling me clearly. That helps a lot. Based on what you're describing, this could be your testicle twisting on itself, which cuts off its own blood supply. This is a true emergency, and every minute matters for saving it. We're going to get you seen by the surgical team immediately and get you something for the pain right now.
- Patient
Okay. Please hurry, it really hurts.
Flow at a glance
The route through the history
- Invite the story while assessing urgency
- Establish sudden onset and radiation
- Rate severity and associated vomiting
- Ask about relief with elevation (Prehn sign)
- Screen for trauma and infectious causes
- Review background, medicines, and allergies
- Explore the patient's fear about fertility
- Summarize and activate the surgical emergency pathway
Free · No card · No account
Practice this patient conversation out loud
Ask the questions in your own words, hear an AI patient respond, and use live feedback for your next speaking attempt.
Editorial record
Tied to one reviewed case
This model uses a fictional Bedside English case as its source. The page and pre-generated WAV audio are checked against the same transcript and source-case fingerprints.
Editorial update: