On the morning of August 28, 14-year-old Yang Yang (pseudonym) came to the Urology Department of Nanjing Hospital of Integrated Traditional Chinese and Western Medicine accompanied by his family. Shi Songshan, director of the Urology Department II, diagnosed him with testicular torsion, and successfully performed the operation on the child during the golden period of treatment, avoiding pain and regret for the family.
Playing badminton too much caused the “balls” to twist 360 degrees
“The boy played badminton the day before he came to see the doctor and exercised quite a lot. He felt pain in his scrotum around 5 a.m. the next day. When he came to the outpatient clinic in the morning, after questioning, I basically determined that the boy had testicular torsion. We immediately opened a green channel and successfully completed the operation within the golden treatment time of six hours.” Director Shi Songshan introduced that during the operation, it was found that the testicle had twisted to 360 degrees. After the operation, the patient recovered well.
Testicular torsion, also known as spermatic cord torsion, is the clockwise or counterclockwise rotation of the testicle along the longitudinal axis of the spermatic cord, causing testicular blood flow obstruction. The greater the rotation angle and the longer the time, the greater the chance of testicular necrosis caused by blood flow obstruction. Director Shi Songshan told reporters that the typical symptoms of testicular torsion are severe testicular pain, which may be accompanied by lower abdominal pain, nausea, vomiting, fever, scrotal redness and swelling, etc. In severe cases, it can lead to testicular ischemia and necrosis. The disease is more common in boys aged 2 to 18 years old, and often occurs after intense exercise, at night or just after waking up.
Experts remind that there are many reasons for “testicular pain”, such as epididymitis, varicocele, testicular torsion, etc. The most dangerous one that needs urgent treatment is testicular torsion. If medical treatment is not timely, the necrotic testicles can only be removed surgically.
Boys should not sleep with their eggs pressed down; 6 hours is the golden period for treatment
Director Shi Songshan pointed out that testicular torsion often occurs during intense activities or vagus nerve excitement during sleep, penile erection, and changes in posture during sleep that cause the legs to constantly squeeze the testicles, causing the testicles to be compressed or displaced from time to time. So boys should not sleep with their testicles pressed down.
If the testicle torsion lasts for less than 6 hours, the chance of successful testicle rescue is 90%; if it lasts for more than 12 hours, the survival rate is very low. Testicular torsion causes testicular ischemia for 8 to 12 hours, and the testicle will suffer irreversible damage: 80% of testicular tissue ischemic and necrotic, loss of function, and loss of value for preservation. Even if the contralateral testicle is normal, it may cause infertility, because the destruction of the “blood-testis” immune barrier can expose antigens from germ cells and sperm to the systemic circulation, leading to the production of anti-sperm antibodies. Therefore, when a boy has “testicular pain”, he must tell his family and ask them to take him to the hospital as soon as possible.
Make a preliminary judgment on whether it is testicular torsion. Remember this word is very important!
Director Shi Songshan said that the biggest characteristic of testicular torsion is pain! At first, the pain is mainly in the lower abdomen or groin, and after a few hours, the pain will move to the scrotum. So when the child says “stomach pain, testicle pain, pee pain”, parents should be extra vigilant. If the baby cannot speak yet, pay attention to whether they will cry for unknown reasons. Along with the pain, the testicles are lifted up and placed in a horizontal position, and the scrotum is red, swollen, and tender. If the child has fever, nausea, and vomiting, the possibility of testicular torsion is greater.
In addition, incorrect sleeping posture, intense activities, testicular diseases, climate change, scrotal trauma, etc. can all induce testicular torsion. To prevent it, you should pay attention to the following four points: First, let your child sleep in a supine position, not prone or side-lying for a long time, to avoid the testicles always being squeezed between the legs; second, avoid letting your child do overly intense exercise; third, usually let your child wear loose, breathable underwear and pants to keep the testicles comfortable and dry; fourth, it is best to rinse the testicles with warm water when bathing to increase the testicles’ tolerance.
Correspondent Yang Pu
Yangzi Evening News/Ziniu News reporter Lv Yanlin
Proofreading Faye Wong