14-year-old boy lost part of his reproductive function due to genital pain and ice pack

Because the pain was not too severe, the family was subjective and applied ice to the scrotum.

Hanoi Medical University Hospital has just performed surgery on a case of testicular torsion due to cold weather.

The case of a teenager named NMN (14 years old, Hanoi) showed signs of pain in the scrotum. Because the pain was not too severe, the family was subjective and applied ice to the scrotum. The next day, the pain did not subside, so the child was taken to Hanoi Medical University Hospital, Branch 2 (Truong Cong Giai, Cau Giay, Hanoi).

Here, the child was diagnosed with left testicular torsion at 18 hours. Testicular ultrasound results showed an enlarged left spermatic cord with a very characteristic "whirlpool" image.

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The doctor operated on the patient. 

The patient underwent surgery to untwist the testicle, it twisted 1.5 times, the parenchyma was dark purple with only partial blood supply. The prognosis is that the testicle will lose some function later.

Testicular torsion is a medical emergency. If not treated promptly, there is a high risk of having to remove the testicle.

The case of patient NKP (14 years old) is an example. Previously, P. was taken by his family to a private clinic near his home and was diagnosed with orchitis. Antibiotic treatment did not help. 12 days later, seeing that the swelling and redness of his testicles were increasing, his family took him back to Hanoi Medical University Hospital for a check-up.

Here, the child was diagnosed with testicular torsion. However, because he arrived at the hospital too late, the doctor was forced to remove the completely necrotic left testicle.

According to Master - Doctor Do Ich Dinh, Department of Andrology and Gender Medicine, Hanoi Medical University Hospital, testicular torsion can occur in men of all ages, but is common in young people (89% under 25 years old).

The disease often starts when sleeping, during strenuous activity or when the weather turns cold, causing the scrotal muscles to contract.

Some risk factors for testicular torsion include pre- or post-pubertal age, genetics, bell-shaped testicles, long spermatic cord.

Patients with testicular torsion often have symptoms such as sudden and severe pain in one testicle, swollen and painful scrotum, pain that can spread upward, the twisted testicle hanging higher than the opposite side. Sometimes testicular torsion can be atypical with mild pain, little swelling or only detected when the child is fussy, nauseous.

Dr. Dinh said that there are two factors that affect the prognosis of testicular torsion: the degree of torsion and the duration of torsion. The degree of torsion affects the rate of destruction of the testicle; the tighter the torsion, the more anemic the testicle and the more likely it is to become necrotic sooner.

Symptoms of testicular torsion in most patients are swelling and pain on one side of the scrotum, the pain appears suddenly and increases gradually. Some studies show that the above symptoms often appear when the man is sleeping, occurring in 50% of cases.

Pain in the scrotum: appears suddenly, the pain gradually increases in intensity, tends to spread along the spermatic cord, inguinal canal and pelvic cavity. When holding the testicle up, the pain feels more intense.

For patients who are diagnosed late, the possibility of preserving the testicles is very low. When the testicles are necrotic, surgery to remove the testicles will partially affect the male's fertility. In addition, it can affect the psychology, causing men to lose confidence in sexual intercourse, reduce desire, erectile dysfunction.

Therefore, when experiencing testicular pain, especially sudden testicular pain, people should immediately go to a specialized hospital for timely diagnosis and treatment.

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Lesley Montoya

Update 10 February 2025