Almost every parent dreams of nursing grandchildren from their beloved children in the future. But not everyone knows that it is worth thinking about this even when their future father is still a child. Nikolay Goncharov, head of the urological department of the Volgograd Regional Clinical Hospital 1, will talk about serious illnesses in boys, which can lead to problems with childbirth in the future.
Nikolai Alexandrovich, when is it necessary to sound the alarm?
- Any urgent situation, especially if it requires the intervention of a surgeon, causes concern for parents. In this case, the sooner help is provided, the better the result will be. Of particular concern are genital diseases in boys, because in the future, current parents want to become grandparents.
Acute diseases of the scrotal organs in boys are combined into one group, which is called acute scrotal syndrome. This syndrome is characterized by symptoms common to all diseases of the group: scrotal edema, skin redness, severe pain syndrome. Fever, nausea and vomiting may also occur. Therefore, when these signs appear, an urgent need to consult a specialist.
Sometimes an allergic reaction can be the cause of the reddening of the scrotum, but a doctor's examination is still necessary for differential diagnosis. The specialist will conduct a mandatory ultrasound examination of the scrotal organs, which will allow you to make the correct diagnosis and make the right decision.
What diseases belong to the syndrome of edematous scrotum?
- Torsion of the testicle, epididymitis or orchiepididymitis (inflammation of the epididymis and the testicle itself) and torsion of the testicle hydatid (pendant). The most formidable condition is testicular torsion. This disease occurs in one in five hundred patients with scrotal edema syndrome. It most often occurs in boys and adolescents between the ages of 11 and 15, but can occur at an early age or in a newborn (about 10 percent of cases). In addition, intrauterine testicular torsion occurs, leading to organ atrophy. Testicular torsion is a condition characterized by the rotation of the testicle around its own axis, in which blood flow is disturbed in the vessels that feed the testicle. It leads to malnutrition and death of the testicle. This condition is accompanied by sharp pains in the scrotum, vomiting, then edema and hyperemia appear. Delay is unacceptable here! In this situation, detorsion surgery is performed, or the elimination of torsion, which helps to restore blood flow. An extremely insidious symptom is pain relief a few hours after it occurs. This may mean the onset of the death of the testicle, and not improvement against the background of unqualified treatment.
What is the most common disease?
- Torsion of the testis hydatids or its epididymis. This disorder is the cause of Acute Scrotal Syndrome in about 45 percent of patients and can occur at any age. Testicular hydatida is a small remnant of embryonic tissue that is connected to the testis in the form of an "earring" on a thin stem. Torsion of the hydatids leads to the appearance of the characteristic symptoms that I mentioned above. But unlike testicular torsion, the pain syndrome is less pronounced, so the characteristic symptoms do not develop so rapidly. Treatment is only operative: it is necessary to remove the twisted hydatidum, otherwise the inflammation will go to the testicle itself, which subsequently will certainly affect the ability to bear children.
That is, there is no other way out except for the operation?
- Yes. Only an urgent visit to a surgeon or urologist and immediate surgical treatment can save the testicle. For example, orchitis (epididymitis), inflammation of the testicle (or its epididymis) in most cases does not require surgery. This disease can occur in children of any age. Very often it develops against the background of various viral diseases. A typical example of infectious orchitis is with mumps. Chronic lower urinary tract infection can also lead to orchitis. Antibacterial and symptomatic therapy can effectively cure a child. And with torsion of the testicles or testicular hydatids - only an operation.
But don't be afraid of surgery. In most cases, treatment for acute scrotal syndrome does not require lengthy hospitalization. After discharge from the hospital, treatment continues on an outpatient basis under the supervision of a urologist and a surgeon of the polyclinic. At home, all doctor's prescriptions must be strictly followed.
What can cause torsion at all?
- A prerequisite for torsion of the testicle or testicular hydatida may be its excessive mobility, due to the lack of normal attachment of the organ to the bottom of the scrotum. A testicle that has not descended into the scrotum (with cryptorchidism) can undergo torsion. In children, testicular torsion is often associated with prematurity, morphological and functional immaturity of the reproductive system, and disproportionate growth of the genitals. And the direct factors provoking torsion are usually scrotal injuries, active movements, outdoor games, physical activity.
Is there any kind of disease prevention?
- Unfortunately, there is no specific prophylaxis. It is important to remember that if you experience pain and swelling in the scrotum, you should immediately consult a doctor to rule out testicular torsion or testicular hydatids. Only a timely operation will allow you to keep the child's health and become a father in the future.