Hyderabad: Urologists at the Asian Institute of Nephrology & Urology (AINU) here rescued an 18-year-old student from an impending loss of one testis due to testicular torsion, a form of twisted testicle.
Thorough background check by the doctors revealed that masturbation triggered this incident. One must be aware, irrespective of the cause, testicular torsion requires immediate medical attention and surgical intervention in order to reduce the risk of testicular loss, said Dr Raghavendra Kulkarni, Consultant Urologist, AINU, Secunderabad.
This adolescent boy, a resident of Hyderabad, was initially brought to AINU because of mild left testicular pain with associated left groin pain. Medical examination was normal except for minimal tenderness. The boy and his accompanying mother were alerted of the possibility of Intermittent Testicular Torsion (ITT) and hence was advised to undergo surgical exploration.
Four days after the first consultation, in view of acute worsening of testicular pain with new onset testicular swelling, the boy was rushed back to AINU. Examination confirmed enlarged painful left testis with fluid in the left sided scrotum. Bedside scrotal scan showed fluid filled in the left sided scrotum with normal colour flow pattern of the left testis. This suggested testicular torsion with impending loss of the blood supply. The boy was immediately taken up for the operation, he was relieved of the pain and the testis was successfully salvaged, said Kulkarni.
Testicular Torsion is due to a congenital abnormality that causes the testicle to twist around its spermatic cord leading to ischemia and infarction of the testicle. It can occur at any age but usually occurs in young adults/adolescents.
Intermittent Testicular Torsion (ITT) is a very rare entity, the diagnosis of which requires a high level of clinical acumen. Recurrent attacks of ITT or ITT that last too long can result in full blown testicular torsion. In ITT, imaging studies are often misleading as it resolves spontaneously in the majority of the patients. False negativity of Scrotal Doppler is high which can lead to delay in surgery with possible testicular loss.
Urologists say testicular torsion can occur spontaneously else can be precipitated by certain exertional activities like exercising, cycling etc. In such cases, immediate medical attention will be required because the first 4-6 hours are crucial beyond which the damage may become irreversible.
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