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Torsion of the Testis - Part 2

View profile for Kimmo Boote
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The first part of this article can be seen here.

Problems from a medico-legal point of view

  1. Misdiagnosis of epididymitis – this is due to an infection of the surrounding part of the testis, called the epididymis. This too can be painful and can be difficult to differentiate from torsion of the testis.
  2. Atypical presentation - there may not be scrotal pain, or there may be vague abdominal pain. There must be a high index of suspicion and any male with abdominal pain should have this ruled out as a possible diagnosis by clinical examination.
  3. Error in diagnosis- the failure to recognise or consider the diagnosis.
  4. Delay or lack of referral - the failure to consider the urgency for surgical opinion (and subsequent operation to rectify the torsion before the testis is no longer viable).
  5. Lack of radiological examination - this supposes that there is no access to ultrasound investigation, but it should be noted that if there are clear signs, then an operative procedure to look at the testes and to correct any torsion may negate the need for ultrasound examination. It should be noted that ultrasound is experience dependent and not infallible as an investigation tool for picking up torted testes.
  6. Failure to explore - this means that no operation has taken place. This is often due to alternative diagnoses having been considered more likely.
  7. Error in surgical technique – plus no contralateral fixation of the testis. The operation to resolve a torted testis requires incision into the scrotum and examination under direct vision of the testis. Should it be torted and thought to be viable, the testis is untwisted so returning it to its normal position in the scrotum and fixed to the inner aspect of the scrotum.

Costs

The compensation usually awarded for misdiagnosing or failing to diagnose torted testes can fall within the range of £20,000 to £70,000 - the higher end of the bracket relating to associated infertility owing to problems with both testes.

To establish if you or someone you know may have a potential claim for clinical negligence following Torsion of the Testis, please do not hesitate to contact the Clinical Negligence Team at Dutton Gregory Solicitors in Bournemouth on 01202 315005, or email k.marden@duttongregory.co.uk.