{"id":1716,"date":"2021-11-03T21:16:43","date_gmt":"2021-11-03T18:16:43","guid":{"rendered":"https:\/\/dregemeneroglu.com\/cocugumun-yumurtaligi-agriyor\/"},"modified":"2021-11-03T21:20:58","modified_gmt":"2021-11-03T18:20:58","slug":"cocugumun-yumurtaligi-agriyor","status":"publish","type":"post","link":"https:\/\/dregemeneroglu.com\/en\/cocugumun-yumurtaligi-agriyor\/","title":{"rendered":"My child&#8217;s testicle hurts!"},"content":{"rendered":"<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">Our patient, which I will tell you about in the Pediatric Surgeon&#8217;s Journal, is a 13-year-old male.\u00a0\u00a0He woke up in the morning with a very serious pain in his left scrotum, that is, in his left testicle.\u00a0\u00a0Afterwards, he started to feel sick, and when it got worse, they came to us.\u00a0\u00a0In our examination we saw that the left side of the testis was swollen, was higher than the right side, the size of the testis increased by touch, and the sensitivity of the testicle was noticed. The testis rotated around itself. In this case, which we call testicular torsion, we need to operate immediately. Since the conditions of our hospital were very suitable, we quickly supported our diagnosis with the ultrasonography that we had done while we were going down to the operating room.\u00a0\u00a0Yes, the testicle had rotated around itself.\u00a0\u00a0We detorsioned it, and waited a while.\u00a0\u00a0We took a deep &#8220;oh&#8221; when the darkened color started to turn pinker because of the return of the blood circulation.\u00a0\u00a0Yes, we saved the testicle.\u00a0\u00a0Because they came early.\u00a0\u00a0Consider your children&#8217;s testicular pain.\u00a0\u00a0In a study, testicular torsion was found in 16% of sudden onset testicle pain.\u00a0\u00a0Surgery is the only way to save.\u00a0\u00a0Our topic in the Pediatric Surgeon&#8217;s Journal is testicular torsion.\u00a0\u00a0<\/span><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">The patient I told you about a moment ago is not fictional.\u00a0<\/span><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">Testicular torsion is more common in adolescents and newborns.\u00a0\u00a0I plan to describe newborns under a separate heading.<\/span><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">Normally, the testicle remains fixed in its bag from the back and thus cannot rotate around itself.\u00a0\u00a0However, in 17% of men, this fixation does not occur and the scrotum can swing in space like a bell.\u00a0\u00a0In fact, this disorder is called\u00a0\u00a0&#8220;bell clapper disorder&#8221;.\u00a0\u00a0Since it can be 40% bilateral, if there is testicular torsion on one side, we also operate and fix the other intact side.<\/span><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">It is usually seen in men under the age of 30, most often between the ages of 13-14.\u00a0\u00a0Because at this age, the testicles begin to grow rapidly, and when the cremaster muscle, which is the extension of our abdominal muscles and wraps the ligaments of the testicles, is very active, it becomes an invitation to testicular torsion.\u00a0\u00a0Although sports activity is considered among the triggering causes of trauma, it can also occur spontaneously without anything.\u00a0\u00a0Of course, it can also be seen in older men, but the underlying cause at older ages is often a tumor, that is, the presence of a mass.<\/span><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">It mostly affects the left testis, as in our patient, and it can be bilateral in 2%.\u00a0\u00a0About 10% of children with testicular torsion also have a family history of testicular torsion.<\/span><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">Testicular torsion is an important diagnosis for us pediatric surgeons.\u00a0\u00a0If it is delayed, the testis may die because there will be no blood supply to the testis.\u00a0\u00a0In this case, we may have to surgically remove the testis.<\/span><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">Pain begins suddenly in one of the balls, and swelling occurs on that side afterwards.\u00a0\u00a0If it is delayed, the pain will decrease as the testicle dies.\u00a0\u00a0According to our books, one third of patients are accompanied by nausea and vomiting. I&#8217;ve never seen testicular torsion without nausea.\u00a0\u00a0When the inner surface of the leg is touched, the cremaster muscle is stimulated and when it contracts, it pulls the testis upwards.\u00a0\u00a0This reflex, which we call the cremaster reflex, is not seen in testicular torsion.\u00a0\u00a0Because the testis has already rotated around its own cord, the length of the cord has shortened, and in this case, the testis has started to stand laterally instead of vertically and higher than normal. If a history of sports activity or a blow is also given, the way to the operating room is now seen.\u00a0\u00a0Sometimes families say they have had similar findings before.\u00a0\u00a0It makes us think that the testis turned around on its own before and then recovered spontaneously, and again supports our diagnosis.<\/span><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">In fact, all of these are sufficient findings for us to perform surgery.\u00a0\u00a0We can use some scoring tables.\u00a0\u00a0Of course, we have weapons that we can get support such as ultrasonography in cases where we are in between.\u00a0\u00a0Surgery immediately if we are sure of the diagnosis.\u00a0\u00a0But if we are not sure, the sensitivity and specificity of color doppler ultrasonography is almost 100%.\u00a0\u00a0There are other methods such as scintigraphy, but we do not use it much in our routine clinical practice.\u00a0\u00a0I read in a study that a quick evaluation can be made with the help of pulse oximetry devices.\u00a0\u00a0I think it makes a lot of sense, but frankly, it&#8217;s not needed at all.<\/span><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">It is also reported that testicular torsion can be corrected externally without surgery.\u00a0\u00a0But it is so painful that the children absolutely do not allow us to touch it.\u00a0\u00a0We have a hard time even inspecting.\u00a0\u00a0In addition, the manual external correction method only saves time, the surgery is still performed.<\/span><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">Surgery is needed as soon as possible.\u00a0\u00a0After the first six hours, the testis begins to die.\u00a0\u00a0It is reported that 80% of the testicles die in a waiting period of 36 hours.\u00a0\u00a0In the surgery, as I just explained, we retorsion and fix the rotated testis by making an incision in the middle of the ball and sewing it into the scrotum, and then we also fix the other side, as we know that the same situation can develop on the other side.\u00a0\u00a0Of course, if it&#8217;s too late, if we come across a black, that is, dead testicle, we have to take the testicle.\u00a0\u00a0In a recent study, it was published that the testicles had to be removed in almost one-third of testicular torsion operations in children.<\/span><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">Although our results are generally good after the surgery, shrinkage, abscess, and infection can be seen in the testicles, which we think we have saved, over time.\u00a0\u00a0Productivity rates can drop for a variety of reasons.\u00a0\u00a0In the future, we may need to place a testicular prosthesis for aesthetic reasons in children whose testicles we have had to take.<\/span><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">\u00a0It&#8217;s best to take testicular pain in children seriously.\u00a0<\/span><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">We have come to the end of our journey.\u00a0\u00a0<a href=\"https:\/\/www.youtube.com\/watch?v=Gwm-YH3ima4\"><span style=\"text-decoration: underline;\"><span style=\"color: #3366ff; text-decoration: underline;\"><strong>Click like if you want to watch the video<\/strong><\/span><\/span><\/a>, subscribe, follow us on <a href=\"https:\/\/www.instagram.com\/dregemeneroglu\/\"><span style=\"text-decoration: underline;\"><strong><span style=\"color: #3366ff; text-decoration: underline;\">Instagram.<\/span><\/strong><\/span><\/a><\/span><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">And stay happy.<\/span><\/h5>\n<h5 style=\"text-align: justify;\"><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">Prof. Dr. Egemen Ero\u011flu<\/span><\/h5>\n<h5 style=\"text-align: justify;\"><span style=\"font-family: arial, helvetica, sans-serif;\">October 2021<\/span><\/h5>\n","protected":false},"excerpt":{"rendered":"<p>Our patient, which I will tell you about in the Pediatric Surgeon&#8217;s Journal, is a 13-year-old male.\u00a0\u00a0He woke up in the morning with a very serious pain in his left scrotum, that is, in his left testicle.\u00a0\u00a0Afterwards, he started to feel sick, and when it got worse, they came to us.\u00a0\u00a0In our examination we saw [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":1707,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[],"class_list":["post-1716","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-en"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>My child&#039;s testicle hurts! - Prof. Dr. Egemen Ero\u011flu<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dregemeneroglu.com\/en\/cocugumun-yumurtaligi-agriyor\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"My child&#039;s testicle hurts! - Prof. Dr. Egemen Ero\u011flu\" \/>\n<meta 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