Final answer:
The most appropriate management for a 31-year-old male with scrotal discomfort and swelling is to evaluate for chronic epididymitis. Treatment typically involves antibiotics, anti-inflammatory drugs, painkillers, and physical support.
Step-by-step explanation:
The most appropriate management for a 31-year-old male presenting with dull, aching, left-sided scrotal discomfort, fullness, and intermittent swelling for 6 months is to evaluate for chronic epididymitis. Epididymitis is inflammation of the epididymis, which can cause pain and swelling in the scrotum. Although the transillumination and Prehn sign are negative in this case, ruling out testicular torsion, the patient's clinical presentation and duration of symptoms are consistent with chronic epididymitis.
If a bacterial infection is suspected, both acute and chronic epididymitis are generally treated with antibiotics. Additional treatments often include anti-inflammatory drugs to reduce inflammation of the tissues and painkillers to control the pain. Physically supporting the scrotum and applying cold compresses may also help relieve swelling and pain.
It is important to seek treatment for epididymitis to prevent complications and improve symptoms. If the symptoms persist or worsen despite treatment, further evaluation may be necessary to rule out other underlying conditions.