testicular infarct

What is Segmental Testicular Infarction?

Segmental testicular infarction is a rare and serious condition where a segment of the testis becomes devascularized, leading to tissue necrosis. This occurs when there is a blockage or interruption in the blood supply to a part of the testicle, causing damage to the affected area.

Symptoms and Presentation

The most common symptom of segmental testicular infarction is acute scrotal pain, which can be severe and sudden in onset. The pain may be accompanied by swelling and tenderness in the affected testicle. In some cases, the condition may present with a palpable, painful, and edematous mass in the scrotum.

Differential Diagnosis

Segmental testicular infarction can be challenging to diagnose, as its symptoms and presentation can mimic other conditions such as epididymo-orchitis (inflammation of the epididymis and testicle), testicular torsion, or even testicular cancer. A correct diagnosis is essential to prevent unnecessary surgical interventions.

Risk Factors

While the exact cause of segmental testicular infarction is often unknown (idiopathic), some risk factors have been identified, including:

• Polycythemia (a condition characterized by an excess of red blood cells)
• Intimal fibroplasia of the spermatic artery (a condition affecting the blood vessels in the scrotum)
• Sickle cell disease
• Trauma to the testicles

Importance of Early Diagnosis

Early diagnosis and treatment are crucial to prevent further damage to the affected testicle and preserve fertility. If left untreated, segmental testicular infarction can lead to loss of the testis.

References:

[1] by HL Jin · 2022 · Cited by 2 — Segmental testicular infarction mostly occurs in young men aged 20–40, and its typical clinical manifestation is acute scrotal pain, which needs immediate attention. [2] [3] by YUEH SHEN · 2015 · Cited by 13 — The most common symptom of segmental testicular infarction is testis pain, which is unspecific and indistinguishable from that of other scrotal diseases. [4] by GC Fernández-Pérez · 2005 · Cited by 163 — In this article, we describe the most relevant radiologic findings in 12 cases of segmental testicular infarction studied with sonography and MRI. [10] Segmental testicular infarctions are uncommon testicular lesions that present with pain. They affect only a segment of the testis that is devascularised with normal remaining testicular parenchyma. [11] Testicular infarction is the necrosis of the gland tissues due to circulatory disorders. Symptoms depend on the prevalence of the process. With segmental infarction, a painful dense formation is palpated, accompanied by edema.

Common Signs and Symptoms of Testicular Infarction

Testicular infarction, also known as segmental testicular infarction, is a rare condition that affects only a portion of the testis. The symptoms can be severe and require immediate medical attention.

• Sudden, severe pain in the scrotum: This is the most common symptom of testicular infarction, often described as sharp or stabbing pain (1).
• Swelling of the scrotum: Inflammation and swelling of the affected area are also common symptoms (4).
• Abdominal pain: Some patients may experience abdominal pain due to referred pain from the scrotal region (4).

Other Possible Symptoms

In addition to these common symptoms, some patients may experience:

• Acute onset of testicular pain: This is often described as sudden and severe, similar to testicular torsion or epididymo-orchitis (2, 3).
• Wedge-shaped, avascular hypoechoic lesion: This is a characteristic finding on ultrasound examination, indicating a segmental infarction (8).

Important Note

It's essential to seek immediate medical attention if you experience any of these symptoms. Testicular torsion and epididymo-orchitis are other conditions that can present with similar symptoms, but require different treatment.

References:

(1) [Context 1] (2) [Context 2] (3) [Context 3] (4) [Context 4] (8) [Context 8]

Conservative treatment is often adopted for segmental testicular infarction, which typically involves antibiotics and analgesia [1]. However, the definitive diagnosis can only be established after a thorough examination, including contrast-enhanced ultrasound and MR imaging [3].

In most cases, conservative management with antibiotics, vasodilation, and anticoagulation is the primary approach to treatment [7]. This conservative treatment aims to alleviate symptoms and prevent further complications.

It's worth noting that surgical intervention may be necessary in some cases, particularly if there are signs of testicular torsion or other complications [14].

In general, the goal of treatment for segmental testicular infarction is to preserve the affected testicle and prevent further damage. This can often be achieved through conservative management, but surgical intervention may be required in more severe cases.

References:

[1] Context 1: Treatment on most cases is conservative with antibiotics, analgesia and ...

[3] Context 3: Background Segmental testicular infarction is a rare condition that often occurs in the upper pole of the left testicle and usually presents with acute onset of scrotal pain. Contrast-enhanced ultrasound and MR are essential for diagnosing and differentiating segmental testicular infarction in clinical practice, and conservative treatment can only be adopted after a definitive diagnosis.

[7] Context 7: by Y Li · 2024 — The current primary approach to STI treatment is conservative and involves antibiotics (3–5 days) administration, vasodilation, and anticoagulation. Surgical ...

[14] Context 14: Testicular infarction due to compressive hydrocele or hernia Testicular infarction due to other vascular insult (cord injury, thrombosis) ... The definitive treatment for testicular torsion is scrotal exploration. After sharply entering the scrotum, the tunica vaginalis is opened. Then the testis detorsed and wrapped in a