Testicle Pain

[medic417]

Palpation allows you to determine more fully what is going on with your patient. Even if it does not change your care it allows you to give a better description which in turn hopefully gets the doctor to take it seriously and check it out more quickly. Sorry just "because it does not change care in the ambulance" is a lazy medics way of not doing patient care properly.

And JP it really is not a bad idea to look at adding to the proper exam techniques in the ambulance. Perhaps I can get it added into the next national curriculum. Thanks for the idea.

 

[redcrossemt]

So... you give all of your multisystem trauma patients a digital rectal exam to test for sphincter tone, correct?

Honestly, we probably should be. No reason for the hospital to take a patient off the backboard if it's indicated, and we've done a good exam of the patient's posterior - including rectal tone.

 

[blevinsjosh]

Tearing pain anwhere with abdominal pain. and rapid decrease in patient condition and hypotension.... always consider a AAA

 

[matt.anderson]

I had this same scenario yesterday afternoon. 68 y.o. male with R testicle pain x1 day. Pt stated it was like someone was "ripping" his testicle in two. He said pain also radiated around side to kidney area, so at first I thought kidney stone, but no hematuria or hx of kidney stones. I also considered the torsion and epididimytis, and also hernia since he stated he had a hernia repair in the past. No abdominal pain with palpation, and no pulsating mass. His pressure stayed elevated during t/p. 170/96 ish. HR around 100. No change in LOC or skin during t/p. I jokingly told the doc at the ER he was having a AAA, referring to this thread, and we both laughed about it. And then when I came in on a later run, that doc pulled me aside and told me that the pt had gone to surgery for a AAA. So I just wanted to say thanks for posting this thread, because it helped me out yesterday.

 

[MMiz]

That's awesome, thanks for sharing. Stick around and contribute, we're glad to have you.

 

[JMFL]

Aaa?

Whats AAA? The car service?

 

[JPINFV]

abdominal aortic aneurysm

 

[blevinsjosh]

aaa

Aaa is a abdominal aortic anryrisim

 

[Eydawn]

Why do a manual exam of the testicles? Because you are the first line of information-gathering, and if you miss something significant you extend the time in which it takes for that significant sign to be noticed by someone else. Digital rectal tone may also provide useful information, but as it is part of a doctor's trauma exam, it doesn't necessarily need to be done twice... it indicates one specific thing, rather than allowing you to rule out or rule in several possibilities.

Manual palpation of testes: Are they hot to the touch? Possible infection. Do they not feel equal in size? Possible rupture. Is one no longer "in the sack" as someone else said? Good to know, to get a doc onto it quicker. If you don't expose and palpate the area, how do you know that there isn't something really nasty and potentially systemically significant going on like an infection of the scrotum that has perforated?

Just my take on it. I get it- none of us wants to be handling grampa jewels. Trust me. Working in an assisted living, I know who was a "freeballer" and who wore tighty-whities from giving showers and doing topical treatments... and yeah, it's nasty, but if there was a major complaint of pain you bet I'd be looking and feeling so I could give a much better picture to the next higher person in the medical chain.

Wendy
CO EMT-B

 

[phideux]

A body part is a body part. If somebody complains that their upper arm hurts, at a minimum you are gonna cut off their shirt, look and probably have a feel.
Like Eydawn said, "none of us wants to be handling grampa jewels." But if the chief compliant is a tearing pain in their testicles, you are at least gonna have to look, if not touch. Parts is parts.

 

[Yurong]

I had this same scenario yesterday afternoon. 68 y.o. male with R testicle pain x1 day. Pt stated it was like someone was "ripping" his testicle in two. He said pain also radiated around side to kidney area, so at first I thought kidney stone, but no hematuria or hx of kidney stones. I also considered the torsion and epididimytis, and also hernia since he stated he had a hernia repair in the past. No abdominal pain with palpation, and no pulsating mass. His pressure stayed elevated during t/p. 170/96 ish. HR around 100. No change in LOC or skin during t/p. I jokingly told the doc at the ER he was having a AAA, referring to this thread, and we both laughed about it. And then when I came in on a later run, that doc pulled me aside and told me that the pt had gone to surgery for a AAA. So I just wanted to say thanks for posting this thread, because it helped me out yesterday.

Hey no problem! Glad I could help a brother out.