Waiting Testicular Torsion - August 2021

Incident Summary

Patient presented to the Emergency Department with pain in their right testicle that had been present since that morning. They were seen by a Locum Surgical Registrar (LSR) who sent the patient home to return the next day for an Ultrasound Scan (USS) due to period of time since the onset of pain. The patient returned for the USS in the morning which demonstrated no vascular flow in the testicle and testicular torsion was confirmed (the testis twists and rotates, trapping the spermatic cord and causing the blood supply to the testis to be cut off). The consultant Urologist was contacted, and the patient was taken immediately to theatre where the right testicle was removed.

Summary of Findings

• Improved awareness of presentation and management of urological emergencies including testicular torsion for surgical trainees is essential.
• The actions for this incident have been incorporated into the action plans from previous torsion incidents including escalation of patients with testicular pain and new guidelines for surgical exploration.
• A new pathway has since been put in place from ED admission to contact urology specialist.

Urgent, Emergency and Eldercare Medicine Learning Summary February 2022