APPENDIX 8 |
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TESTICULAR PAIN WITHOUT A SPECIFIC DIAGNOSISTesticular pain is unusual in a young boy, but when it occurs it can be serious.
CAUSES AND TREATMENT
INJURY OR DIRECT BLOW TO THE GROIN--The pain is often severe, leading to crying and doubling up. An ice pack will relieve the discomfort, which should be gone in an hour. If the boy's pain persists or worsens, particularly if there is swelling and discoloration, contact your son's physician.
TWISTING OF THE SPERMATIC CORD (torsion) THIS IS AN EMERGENCY!--The spermatic cord is a tube attached to the upper pole of the testes. It contains the vas deferens (which transports sperm), blood vessels, nerves, and muscle. If it twists, the blood supply to the testis is cut off and there is a danger of infarction (death) of the testicular tissue from poor circulation. As this develops, the testis swells and becomes painful. Later a fever, abdominal pain, and vomiting develop. The only treatment is emergency surgery to untwist the spermatic cord and fix the testis to the scrotum so that retwisting cannot occur.
TWISTING OF THE SMALL TESTICULAR APPENDAGE--More common is a twist of a testicular appendage (torsion of the appendix testis). This is a small, normal structure that protrudes from the testis. It may twist and die, causing symptoms that are indistinguishable from a twisting of the entire testis. The testis in this condition remains alive. Surgery may be necessary to rule out the possibility of torsion of the entire testis and to alleviate the pain this condition causes.
BACTERIAL INFECTION--Bacterial infection of the epididymis (an elongated, cordlike structure along the back of the testis) occurs in adolescence and occasionally in younger children. Often it is associated with a urinary tract infection.
TESTICULAR TUMORS--Testicular tumors are rare causes of pain in the testes.
MUMPS--Testicular pain can occur with mumps but is almost never seen in children who have not reached puberty.
HOME CARE
When the exact diagnosis is not clear, call your doctor if:
Your son's temperature continues to rise.
The testicle becomes harder.
The testicle becomes larger.
The pain continues to get worse.
Nausea or vomiting begin.
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