In which situation would both Prehn sign and cremasteric reflex be present?

The presence of both the Prehn sign and the cremasteric reflex is typically seen in the case of epididymitis. The Prehn sign involves alleviation of pain when elevating the affected testicle, which is often observed in epididymitis due to the inflammatory nature of the condition. In contrast, the cremasteric reflex, which involves the contraction of the cremaster muscle and elevation of the testicle when the inner thigh is stroked, remains intact in epididymitis, indicating that the underlying testicular structure is still predominantly functioning normally.

In contrast, conditions like testicular torsion usually present with severe, sudden pain and lack of the cremasteric reflex due to the disrupted blood supply. Testicular cancer may not show significant acute signs or tenderness and generally does not present with the Prehn sign. Orchitis, while it can cause testicular pain and inflammation, may also differ in the presentation of these signs due to the underlying etiology and severity of the inflammation.

Thus, in the scenario of epididymitis, both the Prehn sign of pain relief upon elevation and the preserved cremasteric reflex are consistent with the inflammatory process affecting the epididymis while keeping the testicular blood supply intact.