Dear Doctor, My 14-year old son came home from camp this week and said another boy grabbed his testicles, squeezed them and pulled down hard for a number of minutes.
My son has since complained of pain, particularly in the right testicle. What should I do?
Answer: I am sorry to hear that your son had to endure such an attack. The main complication following trauma to the testicles is the risk of testicular torsion. Ideally, your son should have a testicular ultrasound scan and a clinical examination by a doctor.
Testicular torsion is when a testis twists around in the scrotum and may cut off the blood supply to the testes. It most commonly occurs in teenage boys but can happen at any age.
This condition often occurs spontaneously and can be intermittent (come and go). In some patients the tissues that surround the testis in the scrotum are lax, therefore, the testes can move around in the scrotum more than usual. A testis with its blood supply cut off is likely to become damaged and die unless the blood flow is quickly restored. If surgically corrected within 4-6 hours of onset the outcome is favourable with 100pc viability of the testis. Twelve hours following torsion the viability is only 20pc.
The main symptom is an abrupt onset of severe pain, within a few hours, often much more quickly. The pain is in the affected testis, but may also be in the lower or middle of the abdomen (due to a shared nerve supply). In about half of cases, symptoms start in the night, and the pain wakes you from sleep. The affected testis soon becomes tender, swollen and slightly elevated. Nearly 90pc of patients report nausea and vomiting.