I’m not a huge fan of testicular pain. In general, the vast majority of the time, I can never really figure out what is causing it. Of course you rule out the bad (but rare) stuff like testicular torsion or cancer but with the exception of a hydrocoele, I can rarely tell exactly what the cause is.
The other day, a guy came in with this complaint. He looked normal enough and did not appear to be ill at all. The pain started about 5 days ago and he seemed like he considered it more of an irritation. So it was with immense dismay that when I peered under his gown I saw that his scrotum was about 5 sizes bigger than it should, it was deeply red and had boggy, peeling skin on it!
I immediately went from “OK, order the sonogram, check the urine, blah, blah, blah, to HOLY CRAP, call a surgeon, start some antibiotics!!!’
The guy had Fornier’s Gangrene and went rapidly to the OR where most of the skin off his testicles, perineum, and lower abdominal wall were excised. Luckily, he is still alive.
Oooohh , f*** .
“most of the skin off his testicles”…
Does this mean the scrotum, or a membrane on the testicles itself? If the scrotum (which I’m guessing), what’s the long-term result? Rebuild the scrotum from imported skin, or sew the testicles up into an ascended position?
Nice, I was eating.
Hey, great save on the balls! Hopefully the guy got a pic of himself (for Match.com and Craigslist and such) in some Levi’s before you started treating him.
Hope this finds you well, bud.
Jim
how rapidly did his balls change size? were they normal one day, and insanely huge the next, or was it more gradual? i’m trying to figure out why someone would wait five days to seek treatment for that sort of insanity…
Holy crap indeed! *shudders* In our teaching hospital we had a guy who had FG and needed his penis re-wrapped with skin flaps, he later married the surgeon. I guess he was pleased with the result. ;-)
Can’t imagine what that’s going to do to his self esteem.
Wow, I would have thought you and I were talking about the same patient, but mine had a far less happy outcome. He had his skin removed from mid thigh to the epigastric area, including scrotum and penis. I would say he was less than fortunate to have survived. He was palliative care at the point he got to me. It took three timeouts and three morphine boluses to make him comfortable enough to change his dressings.
If we are talking about horrific penile things… had a guy last night with a through and through GSW to the shaft of his penis. All he wanted to know was when can he go home.
Isn’t an infection of the epididemus fairly common? I’ve had it twice.