Miss Shabnam Undre
Consultant Paediatric Urologist East and North Herts NHS Trust and Paediatric Representative, BAUS
Prof James Green
Consultant Urologist Barts Health and President of the RSM section of Urology
Testicular torsion is a time-critical medical emergency that can have serious long-term implications if not diagnosed and treated promptly.
Testicular torsion is caused by the twisting of the blood supply of the testis, leading to reduced blood flow. If left for a few hours, the testicle could become unsalvageable despite having surgery.
Criticality of testicular torsion
Delay in presentation to a hospital can result in testicular loss, which can have psychological, fertility and cosmetic consequences for young boys. Studies have found that there are several reasons for delay in receiving treatment for testicular torsion within the critical six hours. Delay over 24 hours has been shown to have a low salvage rate, and even testes that seem salvaged at surgery can still be lost within the year.
Lack of torsion education
One of the main reasons for late presentation is lack of awareness among children, parents and teachers. Education about the condition among these groups is urgently needed to explain the importance of seeking help within one hour of having testicular pain that doesn’t resolve.
Delay in presentation to a hospital can result in testicular loss, which can have psychological, fertility and cosmetic consequences for young boys.
How to improve torsion awareness
The ‘Save the Ball’ group — consisting of Professor James Green, Dr Vicky Stubbs, Miss Caroline MacDonald, Miss Nadine McCauley and Miss Shabnam Undre — has been working to promote awareness of this condition as part of personal, social, health and economic (PSHE) teaching in schools.
Fully tested and validated lesson plans and free online resources have been created in conjunction with teachers and students. The PSHE Association has endorsed this and sent out a letter to all schools in England to draw attention to this important health problem and the teaching resource.
However, uptake is sporadic as there is currently little guidance on what health conditions should be taught, so it is difficult for teachers to know which ones to prioritise. That will hopefully change when the Sex Education and Health Curriculum in Schools is reviewed shortly and teaching about torsion is formalised across the whole country.
Prioritising testicular health
Testicular health (torsion and testicular self-examination to diagnose cancer) will hopefully be chosen as highly relevant subjects to teach. Over time, we hope to see a shift in the public’s understanding of testicular torsion; recognition of symptoms; and what action to take. More children will then present earlier to a hospital and reduce the unnecessary loss of testicles that currently occurs, which is preventable. The line ‘I wish I’d known as I would have come sooner and saved my testicle’ can become a thing of the past.