Dr. Nicholas Franco Explains The Urgency Of Acute Testicular Pain: Testicular Torsion Vs. Epididymo-Orchitis
Understanding Testicular Torsion
Testicular torsion, Dr. Nicholas Franco says, is a medical emergency where the spermatic cord, which provides blood flow to the testicle, becomes twisted. This twist cuts off the blood supply to the testicle, leading to severe pain, swelling, and, if not treated promptly, permanent damage or loss of the testicle.
“Testicular torsion is one of the most urgent conditions we encounter in urology,” states Dr. Nicholas Franco.“The symptoms include sudden and severe pain in one testicle, swelling, and sometimes nausea or vomiting. The pain can be so intense that it often wakes patients from sleep.”
The Critical Need for Immediate Treatment
Time is of the essence when it comes to treating testicular torsion. Dr. Nicholas Franco emphasizes that the condition requires immediate surgical intervention to restore blood flow to the affected testicle. The procedure, known as orchiopexy, involves untwisting the spermatic cord and securing the testicle to the scrotum to prevent future torsion.
“If treatment is delayed, the lack of blood flow can lead to tissue death within six hours,” warns Dr. Nicholas Franco.“This can result in the loss of the testicle, which not only affects fertility but can also have significant psychological impacts on the patient.”
Understanding Epididymo-Orchitis
Epididymo-orchitis is another condition that can cause acute testicular pain. However, Dr. Nicholas Franco notes, it differs from torsion in that an infection typically causes it. This infection can affect the epididymis (the coiled tube at the back of the testicle that stores and carries sperm) and the testicle itself.
“Epididymo-orchitis usually presents with pain and swelling, similar to torsion, but the onset may be more gradual,” explains Dr. Nicholas Franco.“Patients may also experience fever, a burning sensation during urination, and a discharge from the penis, indicating the presence of an infection.”
Causes and Risk Factors
Epididymo-orchitis can be caused by bacterial or viral infections, including sexually transmitted infections (STIs) such as gonorrhea or chlamydia or urinary tract infections (UTIs). In some cases, it may be linked to recent surgery or trauma to the area.
“Men who are sexually active, particularly those with multiple partners, are at higher risk of developing Epididymo-orchitis due to STIs,” says Dr. Nicholas Franco.“Older men, particularly those with an enlarged prostate, may be at risk due to UTIs. Identifying the underlying cause is important to provide the appropriate treatment.”
Treatment and Management
The treatment for Epididymo-orchitis typically involves antibiotics to treat the underlying infection. Dr. Nicholas Franco notes anti-inflammatory medications and pain relievers may also be prescribed to manage symptoms. In severe cases, hospitalization may be required, especially if an abscess has formed or the infection has spread.
“It's crucial to differentiate between testicular torsion and Epididymo-orchitis, as the treatment approaches are entirely different,” Dr. Nicholas Franco emphasizes.“While torsion requires immediate surgery, Epididymo-orchitis is managed medically. Misdiagnosis can lead to inappropriate treatment and potentially severe consequences.”
The Importance of Timely Diagnosis
Dr. Nicholas Franco stresses that any acute testicular pain should be evaluated immediately to determine the correct diagnosis and treatment. Both testicular torsion and Epididymo-orchitis can lead to complications if not treated promptly, making it essential for patients to seek medical attention as soon as symptoms arise.
“Acute testicular pain is a symptom that should never be ignored,” says Dr. Nicholas Franco.“Men experiencing such pain should seek emergency care, as timely intervention can make the difference between preserving or losing the affected testicle.”
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