Testicular Torsion Pain Honeymoons

Mellick, Larry B.; Sinex, James

doi:10.1097/pec.0000000000001286

Cited by 6 publications

(7 citation statements)

References 21 publications

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“…One case report highlighted a delayed TT diagnosis in a patient who was assessed for neurological deficits due to the absence of pain [11]. Another study focused on TT pain, describing the resolution of pain as the "honeymoon period" [9]. Equally, five of our patients reported reduced pain intensity or relief.…”

Section: Discussionmentioning

confidence: 84%

“…In fact, some adolescents experience sexual shyness, leading them to conceal their scrotal complaints and instead report abdominal or inguinal pain, along with other associated symptoms. These patients later admitted that they did not understand the importance of discussing scrotal pain and changes with their families and physicians, often due to feelings of embarrassment [4,6,8,9].…”

Section: Introductionmentioning

confidence: 99%

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Patient Query in Adolescent Testicular Torsion Cases: "Was it Necessary to Mention My Scrotal Pain?"

Mehmetoğlu

2023

Cureus

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This study investigates the reasons for the failure to diagnose testicular torsion (TT) in different healthcare facilities (HCFs) and by various physicians. MethodWe retrospectively analyzed all male patients who underwent TT surgery within the adolescent age group between 2015 and 2023. Healthy adolescent patients who initially presented or were referred to an HCF and were subsequently diagnosed at our hospital for TT surgery were analyzed, focusing on why they were not diagnosed earlier. ResultsA total of 11 patients aged 10 to 17 who were surgically confirmed to have TT at our hospital between 2015 and 2023 were analyzed retrospectively. These patients had been admitted to various public and private HCFs due to the sudden onset of symptoms such as abdominal pain, vomiting, fainting, sweating, and walking difficulties during and after working hours. Four patients had previously been admitted to one HCF, while seven had been admitted two to six times to an HCF. All patients were healthy, and all but one had received age-appropriate education. However, only two of them had reported experiencing scrotal pain. Laboratory tests and/or radiological examinations were conducted on eight patients, and nine patients received medical treatment and/or prescriptions. None of the patients were initially diagnosed with acute scrotum. ConclusionDespite having unrestricted and free access to well-equipped HCFs, the early diagnosis and treatment of TT are not ensured. Factors contributing to this delay include patients' concealment of, or failure to fully disclose, scrotal complaints, as well as physicians' incomplete history taking and genital examinations. The physician's male gender was not found to contribute to an earlier diagnosis of TT. A mandatory genital examination should be included in the emergency assessment protocol for male patients.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Patient Query in Adolescent Testicular Torsion Cases: "Was it Necessary to Mention My Scrotal Pain?"

Mehmetoğlu

2023

Cureus

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“…Scrotal pain is a well-known complaint in acute pediatric male patients. The symptom can be caused by a multitude of clinical conditions and therefore present a diagnostic challenge [ 1 , 2 ]. Testicular torsion is of particular interest as it may lead to the loss of a testicle if not treated promptly by surgical decompression [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

The impact of ultrasound on testicular loss in cases of testicular torsion in children

Buch Kjeldgaard,

Kinder-Klausen,

Nerstrøm

et al. 2024

Pediatr Surg Int

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Purpose Ultrasound as a diagnostic tool in suspicion of testicular torsion is still highly debated. In this investigation, we aimed to evaluate whether time spent on scrotal ultrasonography had a negative impact on testicular loss. Methods Patients’ records containing a scrotal ultrasound and/or surgical procedure codes for testicular interventions on suspicion of testicular torsion were examined. Patients aged 0–15 years admitted during 2015–2019 at Copenhagen University Hospital, Rigshospitalet were included. Results In total, 1566 patients underwent an ultrasound and 142 of these proceeded to surgery while 13 patients proceeded directly to surgery without an ultrasound. The rate of testicular loss with a preceding ultrasound was 23% versus 42% without (p = 0.18). Four cases of testicular torsion were misdiagnosed by ultrasound resulting in a sensitivity of 95.4% and specificity of 95.6%. The mean diagnostic delay from ultrasound examination was 55 ± 39 min, and the mean time from ultrasound to surgery was at 169 ± 76 min versus 171 ± 72 min without ultrasound. Conclusion In a clinical setting, ultrasound provided a reliable tool for the diagnosis of testicular torsion and did not seem to increase the orchiectomy rate.

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“…Classically, TT pain is described as rapid in onset, instantaneously severe, and often accompanied by nausea and vomiting. 1 , 2 A Nigerian study found that, globally, 1 in 4000 males below 25 years of age is affected annually. This study found that TT contributes to male infertility, accounting for 5.8% of testicular insufficiency.…”

Section: Introductionmentioning

confidence: 99%

Is There a Relationship Between Waking Up from Sleep and the Onset of Testicular Torsion?

Alzahrani¹,

Alasmari²,

Altokhais³

et al. 2023

RRU

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Testicular torsion is a serious urologic emergency that can present with unusual or atypical history and examination. Classical pain from testicular torsion is of sudden onset, significantly severe, and is accompanied by nausea and vomiting. However, in some patients, the initial scrotal pain appears to considerably subside within the next few hours. In others, testicular torsion tends to occur while sleeping, and many patients recount a history of being woken up from sleep by intense pain. Furthermore, some patients in this subset can resume normal activities and even sleep through the night with little or no discomfort, without a perceived need for pain medications. Other patients initially experience mild pain, which worsens over time. Consequently, these patients are less likely to be evaluated immediately. In view of these atypical cases, the question remains unanswered regarding sleep as a predisposing factor for testicular torsion. This narrative review focuses on exploring the association between sleep and testicular torsion.

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Testicular Torsion Pain Honeymoons

Cited by 6 publications

References 21 publications

Patient Query in Adolescent Testicular Torsion Cases: "Was it Necessary to Mention My Scrotal Pain?"

Patient Query in Adolescent Testicular Torsion Cases: "Was it Necessary to Mention My Scrotal Pain?"

The impact of ultrasound on testicular loss in cases of testicular torsion in children

Is There a Relationship Between Waking Up from Sleep and the Onset of Testicular Torsion?

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