My son is 8 years old. He complained about a month ago with pain in his lower left groin area, we wrote it off as a hard day of playing and continued on. Last week we took him rollerblading and when we returned home, he was in so much pain that he doubled over. We took him to the ER where we were told to see a an Uroligist to have an exam. The lab work is all negative, he feels great and did shortly after his 15 minute episode last week. The Dr. is guessing torsion and suggests that if it reocurs that we have surgery to correct. My question is what are the dangers if any are there to allow this to happen again? Is this a problem that fix its self or how often will it reocur.
Torsion is a twisting of the testicle within the scrotal sac, resulting in blockage of arteries, veins, and lymphatics. The most obvious symptoms are pain, discomfort, and swelling. Torsion, if left untreated, can ultimately cause the death of the testicle itself, as the blood supply is cut off. Torsion of the testicle can occur at any age, but is most common between the ages of 12 and 18, after which, the incidence slowly decreases. The incidence is estimated at 1 in 4,000 (males under age 25). It can also occur in the neonatal period. Further, there are appendages on the testicle (such as appendix testis), which could undergo torsion, and cause swelling and pain.
The first step in ruling out torsion is a physical exam by your physician. If there is question of torsion, an ultrasound of the testicle, or a testicular scan (nuclear study) will confirm a positive diagnosis. Once diagnosed, surgical intervention is necessary to prevent testicular death. The prognosis for torsion which is discovered and treated early (i.e., within 4 to 6 hours after onset) is good.
Intermittent testicular torsion is a process whereby the full torsion does not occur/persist and the symptoms resolve on their own. It is unclear whether any injury of the testicle occurs in such presentations. However, it is important to be seen and evaluated as described above while the patient is symptomatic, in order to obtain a diagnosis. A variety of predisposing factors have been suggested which put the testicle at risk for twisting; your doctor can discuss these with you. A urologist is the most qualified physician to evaluate testicular problems, including torsion.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
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