A STUDENT had to have a testicle removed after docs took SIX DAYS to spot it had twisted around and cut off the blood supply.
The 20-year-old, named only as Ryan, woke up in agony in the early hours with intense pain in his right testicle and lower abdomen.
He called NHS 111 and was told to contact his GP and despite making five calls from 8am, he didn’t get a call back until just after 11am.
A report by the Healthcare Safety Investigation Branch said that the delay was caused by an incorrect telephone number held for the patient.
When Ryan described his symptoms to his GP, they immediately suspected he had suffered testicular torsion.
It’s caused by the cord, which provides blood flow to the testicle, getting twisted and cutting off the blood supply to the testicle.
He needed emergency treatment so the doc sent Ryan straight to A&E.
But it took emergency staff two and half hours to see him and they diagnosed inflammation of the testis, sending him away with 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.”
On the Monday, he called his mum’s GP surgery and a doctor advised him to continue with the antibiotics prescribed the hospital.
After putting up with the pain for two more days, Ryan was eventually seen by another GP who noted an “apple-sized swelling in his testicle”.
What is testicular torsion?
Testicular torsion occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum.
The reduced blood flow causes sudden and often severe pain and swelling.
Testicular torsion is most common between ages 12 and 16, but it can occur at any age, even before birth.
Testicular torsion usually requires emergency surgery.
If treated quickly, the testicle can usually be saved.
But when blood flow has been cut off for too long, a testicle might become so badly damaged that it has to be removed.
- sudden, severe pain in the scrotum
- swelling in the scrotum
- abdominal pain
- nausea and vomiting
- unusually high testicle
- pain while weeing
It is not clear why it occurs.
Most males who get testicular torsion have an inherited trait that allows the testicle to rotate freely inside the scrotum.
Testicular torsion often occurs several hours after vigorous activity, a minor injury to the testicles or sleep.
Cold temperature or rapid growth of the testicle during puberty also might play a role.
When it is not treated it can cause damage or death to the testicle due to blocked blood flow.
In some cases it can cause infertility.
As the testicle is the organ responsible for producing sperm, any damage to them can impact a man’s ability to have children.
Source: Mayo Clinic
He was referred to the urology emergency clinic at a local hospital where a surgeon diagnosed him with suspected testicular torsion.
Ryan then had emergency surgery to examine his testicle, but docs realised they would have to remove it because the loss of blood had caused the tissue to die.
Speaking afterwards, he 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.
Having an operation to remove my testicle has had a big impact on my life
“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.”
As a result, 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.
Dr Stephen Drage, HSIB’s director of investigations said: “Testicular torsion is a time critical condition where rapid surgery can prevent significant complications.
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“Torsion may also mimic other conditions, making it difficult for health professionals to tell between different causes of testicular pain.
“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.”
The report also recommended that NICE revises the content and accessibility of its clinical knowledge summary on testicular torsion.
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