Sunday, April 14, 2013

If You Look At This And GASP! You Are A Guy

When this boy walked in the door his presenting complaint was obvious.

A very swollen, red, pendulous testicle protruded and swayed as he tentatively goose-stepped into the clinic.

As he carefully sat down the girls all flocked to me.

"What could it be?" they whispered in a curious yet still slightly embarrassed tone.

As I always do, I volleyed the question back to them. How else will they learn if they don't try to think things through themselves?

The quizzical pondering over took the embarrassment.

"OK, lets start with anything that's swollen." I said.

The answers started. "Trauma." "Yes," I replied.

"Cancer." Was answer number two. "Yes, cancer is always on every rule-out list. But in this case the swelling occurred within hours, so it's probably not cancer." Encouraging them to keep thinking.

The answers stopped.

I added the remaining clues. "This is a young intact male, there are no signs of injury, so if it's not blood pooling into the scrotum, then it has to be?..." I wasn't giving up on them coming up with the answer.

Still I provided another clue.

"Think about what happens if you put a rubber band around your finger." The last clue was all that was needed for the collective light bulbs to go off.

Testicles are stored out of the abdomen to keep them cool. They essentially swing in the breeze. Like any swing they can twist on their rope.

If you spin your swing the chains that suspend the swing wrap around each other and that acts like a rubber band around your finger. The blood that is supposed to flow freely starts to pool in the gravity dependent or distally constricted area.

For a guy, that's like a rubber band being placed above your jewels. "OUCH!" The medical term is "testicular torsion."

I did a quick search on Google for "testicular torsion" and found a slew of articles. All of them human, and once again I was reminded that "we all have the same biology." Here is what I found for stats on the human side, "Testicular torsion affects one in 4,000 males younger than 25 is usually diagnosed by a physical exam."

For all creatures with this predicament the treatment is surgery.

For this boy we relieved his pain with a neuter the next morning. 

Problem cured! 

Maybe not the answer every guy wants to hear, but for this boy, (who doesn't need his jewels anyway), "Ah, relief."

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