University student, 20, lost his right testicle ‘because it took doctors SIX DAYS to notice it had twisted around and cut off blood supply’
- The 20-year-old, named only as Ryan, was found to have testicular torsion
- But it took six days for Ryan to be diagnosed with the medical emergency
- The Healthcare Safety Investigation Branch revealed the failings in a report
A university student lost his right testicle because doctors failed to act quickly enough and left him in severe pain for six days.
The 20-year-old, named only as Ryan, suffered testicular torsion – when a testicle twists around and cuts off blood supply.
But it took six days for Ryan to be diagnosed with the condition, considered a medical emergency and needs prompt treatment.
The Healthcare Safety Investigation Branch revealed the failings in a report, calling for a greater awareness of testicular torsion.
The 20-year-old, named only as Ryan, suffered testicular torsion – when a testicle twists around and cuts off blood supply
The independent body said Ryan woke in the early hours one Friday with intense pain in his right testicle and lower abdomen.
He called NHS 111 and was told to contact his GP. Ryan made five calls to his local GP surgery from 8am but was not called back until just after 11am.
The delay was caused by an incorrect telephone held for Ryan on his electronic patient record, and an appointment with another patient that took longer than expected.
Ryan described his symptoms and the GP immediately suspected a testicular torsion, telling him he must go to A&E straight away.
He got there at 11.30am but was not seen for two-and-a-half hours and was then diagnosed with inflammation of the testis and given antibiotics.
The report said: ‘The following day (Saturday), Ryan travelled by train to his family home. Due to the severity of pain, he spent the rest of the weekend in bed.’
He rang the GP surgery where his mother was registered on Monday, and a doctor advised him to continue with the antibiotics prescribed by the hospital.
After experiencing ongoing pain for two more days, Ryan was eventually seen by another GP who noted an ‘apple-sized swelling in his testicle’.
They referred him to the urology emergency clinic at a local hospital. He attended and a surgeon diagnosed him with a suspected testicular torsion.
Ryan then underwent emergency surgery, under anaesthetic, to examine his testicle. His right testicle had to be removed as the loss of blood supply had caused tissue death.
The investigation found that questions used by call handlers for NHS 111 were not sufficiently adequate for spotting testicular torsion.
They have now been amended to increase detection in men up to the age of 25. A series of other recommendations have also been made.
Dr Stephen Drage, HSIB’s director of investigations said: ‘Testicular torsion is a time critical condition where rapid surgery can prevent significant complications.
‘Torsion may also mimic other conditions, making it difficult for health professionals to tell between different causes of testicular pain.
WHAT IS TESTICULAR TORSION?
Testicular torsion is a rare disorder that most frequently affects boys, often around puberty.
It usually needs to be treated as an emergency, with surgeons untwisting the testicle through a small cut in the skin of the scrotum.
It is often caused during physical activity, when the tissue surrounding the testicles has not yet become firmly attached to the scrotum. However, it can also occur while a man sleeps.
If the testicle twists around, it pulls with it the spermatic cord, a narrow bundle of fibres and tissues that runs from inside the abdomen to the testicle, supplying it with blood.
If this remains twisted, it blocks blood flow, causing the testicle to ‘die’ after around six hours. Then it would have to be removed.
‘Our investigation makes recommendations that will help health professionals to make the right decision at the right time to ensure access to rapid surgery where necessary.’
It also recommended that NICE revises the content and accessibility of its clinical knowledge summary on testicular torsion.
Testicular torsion most frequently affects boys and teenagers, with figures estimating it strikes around one in every 15,000.
It usually needs to be treated as an emergency, with surgeons untwisting the testicle through a small cut in the skin of the scrotum.
It is often caused during physical activity, when the tissue surrounding the testicles has not yet become firmly attached to the scrotum. However, it can also occur while a man sleeps.
If the testicle twists around, it pulls with it the spermatic cord, a narrow bundle of fibres and tissues that runs from inside the abdomen to the testicle, supplying it with blood.
If this remains twisted, it blocks blood flow, causing the testicle to ‘die’ after around six hours. Then it would have to be removed.
Ryan said: ‘Experiencing testicular torsion and then having an operation to remove my testicle has had a big impact on my life.
‘At the time, I felt really distressed at the intense pain and not knowing what was wrong.
‘After the operation, I was frustrated that there had been delays in my care and that I had to miss so much of my university studies.
‘I now worry about the future – the effect it could have on my fertility and asking myself if I want to go through another surgery to have a prosthetic fitted.
‘This is my personal experience, but I think that torsion itself and then losing a testicle could affect a man’s well-being in so many ways.
‘I was really glad HSIB looked at my case in depth. I had the opportunity to tell my story and have been involved all the way through the investigation.’
WHAT ARE THE MEDICAL IMPLICATIONS OF LOSING A TESTICLE?
Rob Cornes, a male cancer nurse at the cancer charity Orchid, previously told MailOnline of the dangers.
He wrote: ‘Around 90 per cent of the male sex hormone testosterone, is produced by the testicles.
‘Testosterone is the hormone responsible for secondary male characteristics such as muscle, bone growth, hair pattern, deep voice and a general feeling of well-being in men.
‘It is also responsible for sperm growth. Having one testicle removed should not affect the overall testosterone levels, sex drive or ability to have an erection or fertility.
‘Providing that the remaining testicle is healthy, it should do the job of both.
‘If it is performed for testicular cancer and subsequent chemotherapy is needed, men will be advised to bank sperm as chemotherapy may cause temporary infertility.
‘Men who lose both testicles are likely to have erection problems due to the reduced levels of testosterone. They will also be unable to father a child naturally.
‘When testosterone levels are minimal men will often experience a loss of libido, well-being and may experience lethargy, low mood and depression, weight gain and sometimes breast swelling.
‘In this situation testosterone replacement therapy will be needed. This can be administered in the form of injections, gels or patches but may take some weeks for levels to normalise.’
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