Segmental Testicular Infarction – Is Conservative Management Feasible?

Scrotal Pain Caused by a Segmental Testicular Infarct

“… 1 This condition is usually managed conservatively; however, some undergo orchiectomy if their diagnosis is unclear or there is concern for malignancy. 4 This case highlights steroid use and polycythemia as important risk factors for segmental infarcts, which have not been well reported in the emergency medicine literature. It also illustrates the need for repeat imaging for a patient with persistent or worsening testicular pain as a segmental infarct may not be apparent on initial presentation.…”

MRI-guided conservative management of a left segmental testicular infarction

“…On T2 MRI, a wedge-shaped lesion with clear boundaries of the avascular portions in the testis is seen, whereas enhanced T1 MRI shows an enhanced rim around the defect [2 , 4] . Although we utilized MRI in our case for diagnosis and follow-up, it may not be available in all hospital settings and may not be useful for ruling out tumors in all cases.…”

“…STI is uncommon in patients over 50 years; this typically occurs in 20- to 40-year-olds [1 , 2] . Patients generally present with pain in the scrotal region [4] .…”

“…Color Doppler sonography will typically show a wedge-shaped localized hypoechoic avascular region with reduced blood flow [2] , [3] , [4] . In our case, however, we were able to find isoechoic lesions via Ultrasonography.…”

“…Partial testicular infarction is a unique condition that is mostly idiopathic in nature [1] , [2] , [3] . Clinically, it resembles torsion and testicular tumors, thus making it difficult for urologists to observe or perform surgery [1] , [2] , [3] , [4] . In this case report, we illustrate how radiological investigations can allow the patient to be safely monitored without intervention.…”