A student had to have a testicle removed after five different GPs missed signs of a condition which left him in “severe pain” for six days, an investigation has revealed.
The 20-year-old, identified only as Ryan, awoke one morning to an “intense pain” in his right testicle and lower abdomen.
Around 8:00am he called NHS 11, triggering a chain of missed signs and wrong diagnoses eventually resulting in emergency surgery and the loss of his testical – six days after he first sought help.
Ryan had suffered from testicular torsion, where the spermatic cord attached to the testicle twists, cutting off the blood supply causing severe pain.
If the torsion is not treated in time, the tissue begins to die and can result in the loss of the testicle.
Ryan’s case, documented in a Healthcare Safety Investigation Branch (HSIB) report, was reported by his mother to the HSIB in 2018, after she was dissatisfied with the diagnosis, treatment and complaints procedure by some of the organisations her son went through.
In December 2017, NHS England had also contacted the HSIB with concerns about the “volume of missed and delayed diagnoses” relating to testicular torsion.
The university student said he missed “so much” of his studies due to the ordeal and he is considering getting a “prosthetic” fitted because he is now concerned about his fertility.
He said: “Experiencing testicular torsion and then having an operation to remove my testicle has had a big impact on my life. At the time, I felt really distressed at the intense pain and not knowing what was wrong.”
Following their investigation, the HSIB has recommended; the National Institute for Health and Care Excellence (Nice) revises the content and availability of information on testicular torsion, NHS England ensures that the condition is included on emergency checklists when assessing men under 25 and guidance should be developed to improve call handlers advice in primary medical care settings.
Testicular torsion is a condition, which affects around 1 in 4,000 men under 25 every year.
Since 2016, across England there have been more 3,500 admissions each year with suspected testicular torsion and a proportion of these suffered complications due to misdiagnosis and delay.
Research has found nearly 20 per cent of orchidectomies – surgery to remove one or both testicles – were performed due to missed or delayed torsion diagnosis.
Professor James Green, Consultant Urological Surgeon at Barts Health NHS Trust welcomed the HSIB report.
Prof. Green said: “It reiterates the fact that testicular torsion is an emergency. It is painful and needs to be treated quickly if we are to have a good chance of saving the testicle.
“This detailed report identifies a number of areas that can be improved to minimise delay, and if the recommendations in this report are implemented fewer men will lose a testicle needlessly.”
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