'He'll manage very well with one - poor little chappie'

Hayley Carlin never imagined that her son's stomach pains were the result of a twisted testicle

Hayley Carlin
Wednesday 20 September 1995 00:02 BST
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How would you feel if you had to tell your 12-year-old son that he was going to have an operation on his most sensitive parts - and that he shouldn't be surprised if he woke up with only one testicle?

We were on holiday by the sea during the long hot summer when David suddenly clutched his stomach and began screaming with pain. Although many children are prone to over-dramatising, there was no doubt he was genuinely in agony. By the time we got to see the local GP, the screaming had subsided, although he was vomiting and still in considerable pain.

A kindly young doctor diagnosed "non-specific abdominal pain" and we went home relieved that it wasn't a hernia or appendicitis, which can occasionally occur on the left side. About half an hour later, David told me that, as he put it, one side of his "privates" hurt. He allowed me to look - one year on and I'm sure he wouldn't - and I noticed that one testicle was swollen.

My husband, who was working in London that week, was as puzzled as I was when he heard about David's symptoms. But by the next morning, I was relieved to find that the pain and sickness had subsided and David's colour and appetite had returned to normal. We had a gentle day, with no violent sporting activities, and took in a trip to the cinema. He seemed fine but I could see that although he wasn't complaining, he was slightly uncomfortable when he walked. That evening I decided to pick the brains of a GP friend in London. He was out when I telephoned and I was woken by his return call at midnight. "Rush straight to casualty!" was his horrifying response when I described the symptoms of violent stomach pain and swollen testicle. "Don't be surprised if they need to call a surgeon to operate." "Operate?" I yelled. "What on?"

I had still not grasped the seriousness of the situation until he told me, as gently as possible, that the testicle could have become twisted and would need straightening out. At this point I knew that my quickly rising hysteria was a luxury I could not afford and I concentrated on the thing that most mothers are best at - practicalities. I woke David up, and though he is used to a slightly dotty mother, he thought being dragged off to hospital at 12.02am was barmy even by my standards. A close friend staying nearby was quickly enlisted to stay with my younger, slumbering children - two sons and a daughter. Off we went into the night, not knowing what lay in store.

The local hospital's casualty department treated us faultlessly. An assortment of fellow sufferers had been waiting between four and six hours, while a doctor was dispatched to us within minutes of our initial assessment. Though part of me felt delighted to have jumped the queue, another knew things must be serious.

The young antipodean surgeon who saw us next confirmed this. After examining David, he said bluntly: "Don't feel bad. Your son's left testis has twisted, what we call a torsion, and if you ask me, you've waited too long since the initial onset of pain. That side has in all likelihood been deprived of blood and will have died." Oblivious to my reeling in anguish he continued: "Don't worry, though, having one testicle won't affect his development or fertility and he can manage very well with one." As he left the room, pursued by one very shaken mother, he could be heard muttering, "poor little chappie".

My path after him was blocked by a nurse and I couldn't understand why at this critical time she kept asking whether I had a car with me. On my dazed response in the affirmative, she flourished a map, pointed to a vague position on it and asked whether I would mind driving the 10 miles to another hospital as this one did not cater for paediatric cases.

What do you do in such a situation - sit down and weep or just get on with it? Off we went, at two in the morning, escorted to our car by two leering drunks. In the car I explained to David as best I could the possibility that he might lose a testicle. He seemed extraordinarily blase.

The second hospital was expecting us and shortly before 4am I was ushered tearfully out of the operating theatre to wait while surgery went ahead, almost paralysed with fear. David was still very chirpy.

We were lucky. An hour later, the surgeon emerged to inform me that David's testicle had almost twisted itself back into the correct position. Although it had suffered some discoloration, it still had 80 per cent of its blood supply. Making an incision into the scrotum, the surgeon had been able to restore the blood supply fully and anchor the testicle firmly in place with a few small stitches. The other side of the scrotum was then opened so that the other testicle could be anchored, too - standard practice in such cases.

I now consider myself an expert on this area of the male body. It seems that in some boys and men the lie of the testicles is horizontal and therefore the chance of a torsion occurring in these males is greater, especially during adolescence. It is not very common but it is an easily treatable condition that need have no long-term effects if caught quickly.

The initial severe stomach pains David experienced must have occurred at the time his testicle twisted. It is apparently not unusual for the body to experience "referred pain" in one area when the problem lies somewhere else.

Had the first GP I saw looked further than my son's stomach, the problem could have been dealt with immediately. As it turned out, I am profoundly grateful that although, through ignorance, we waited far too long, we were fortunate enough to get away with it.

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