It's a great day to save a testicle!
Medgeeks with Andrew Reid
Medgeeks
4.8 • 997 Ratings
🗓️ 14 September 2017
⏱️ 7 minutes
🧾️ Download transcript
Summary
A 15 year old male patient is coming to your emergency department complaining of pain in his right testicle. He said the pain began 6 hours ago, mid sleep, and threw up before arriving to the ED.
Physical exam shows a tender, swollen, and slightly elevated right testicle. The cremasteric reflex is absent.
The patient is unable to go to the OR immediately.
What do you do next? Listen to find out!
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Transcript
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| 0:00.0 | What's up guys? It's a great day to be alive and it's a great day to keep a testicle alive and that's what we're going to be talking about today |
| 0:06.3 | Testicular torsion. We're going to be talking about how these patients will present what risk factors to look out how how to diagnose, how to manually reduce |
| 0:13.8 | torsion, and what is the definitive treatment for these patients. But before we |
| 0:17.8 | do I just want to quickly reintroduce myself. My name is Gray Phelps and I'm a |
| 0:21.6 | licensed physician assistant practicing in emergency medicine. |
| 0:24.5 | I just recently partnered with Andrew Reed, the founder of PA boards, and we're really excited to bring you |
| 0:29.6 | guys free educational content on the YouTube and the podcast. |
| 0:34.1 | So if you haven't already subscribed, |
| 0:35.8 | go ahead and do that now. |
| 0:37.4 | So quickly, let's briefly go over the normal anatomy |
| 0:40.1 | of the scrotum because it will later prove |
| 0:42.1 | to be important when understanding the mechanism behind this testicular |
| 0:45.2 | emergency. Here you can see the testicle tunicavaginalis, epidymitis, spermatic cord, and Appendix Testes. |
| 0:53.0 | Testicular torsion results when you have inadequate fixation of the lower pull of the testes to the |
| 0:58.0 | tunicobaginalis. |
| 0:59.0 | When this occurs, the testicle can twist around the Spromatic cord cutting off blood supply to the testicle can twist around the spermatic cord cutting off blood supply to the |
| 1:04.1 | testicle. If not recognized promptly, it can result in serious consequences. |
| 1:08.4 | Testicular torsion has two peak incidences, a small increase in the neonatal period and a large increase during puberty. |
| 1:15.9 | With approximately 65% of cases occurring between 12 and 18 years of age. |
| 1:20.8 | This increased incidence during adolescence is thought to be due to the increased weight of the |
| 1:25.1 | testes during puberty, but ultimately, guys, it can occur at any age. |
| 1:29.6 | Risk factors for testicular torture include testicular trauma, age, vigorous physical activity, and |
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