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Sharp pain in groin area near scrotum, left testicle detached from epididymis. Testicular torsion?

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Practicing since : 1995
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Hello, I am a white 23 three year old male, 5 foot 9 inches 165 with a relatively clean XXXXXXX of health. Two days ago, I was tapping my left foot in my car and I experienced a sharp pain in my groin area between my left leg and my scrotum. I instantly felt a heaviness in my groin area and realized that my scrotum on my left side had lost it's shape. I went home and felt around my left testicle and it feels like my left testicle has become detached from the epididymus. Since that time there has been relatively no pain in that area but I have been feeling a tingling sensation in my scrotum for lengthy periods of time since then. I do not believe my condition to be testicular torsion because I have not felt any major pain or discomfort. Can you give me advice on the situation?
Posted Thu, 12 Apr 2012 in Testicle Problems
Answered by Dr. V. Sasanka 1 hour later

You are probably right - it might not be a testicular torsion but I would still advise you to get yourself examined early and have an ultrasound scan of your scrotum with doppler examination of your testes and spermatic cord at the very least.

If the scan reports are normal, you can rest in the knowledge that there is nothing serious and then your condition should probably become better with scrotal support and mild anti-inflammatory drugs.

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Follow-up: Sharp pain in groin area near scrotum, left testicle detached from epididymis. Testicular torsion? 20 minutes later
So there is no chance that my testicle could have become loose in the scrotum itself?
Answered by Dr. V. Sasanka 28 minutes later
The testis has attachments which prevent it from becoming 'loose in the scrotum' as you said. However, there could be some anatomical anomalies (we call it 'bell clapper' anomaly) where the testis is suspended by an unusually long cord within its covering called the tunica. These are the persons who are prone for torsion of testis.

Torsion of testis when it does come on, as most commonly in adolescents, has sudden onset of severe pain, and the patients often recollect episodes of self-limiting pain experienced earlier. Torsion is a surgical emergency, and needs to be identified and corrected within 6 hours of onset to prevent permanent testicular damage.

Very rarely, torsion can happen of small appendages of testes which also present in a similar fashion. If you have not had a hernia earlier, it is unlikely to be the cause of your present acute condition.

In all probabilities what you have experienced might be an epididymitis or orchitis which resemble torsion closely, and one way of differentiating it is by color flow examination of the scrotal contents.
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