Department of Family and Community Medicine, Brokenshire Hospital Integrated Health Ministries, PhilippinesFulltext PDF
Testicular Torsion (TT) is an emergency which affects approximately 1/4000 males under 25 years. It usually presents as an acute scrotal pain and has been associated with anatomical, traumatic and environmental factors, among others. This is a case of a 24 year old trans woman, presenting with a sudden onset of right scrotal pain and was initially seen at Emergency Room (ER) – OutPatient Department (OPD), Family Medicine service. Doppler ultrasound revealed decrease flow in the right testicle suggestive of TT. Detorsion and orchiopexy were advised but patient refused and wanted to have bilateral orchiectomy instead. Consequences of bilateral orchiectomy were presented to the patient as well as the long – term prognosis of detorsion and orchiopexy. A delay in patient’s consent led to a 10 h gap after the first presentation of the symptom. Radical orchiectomy, right done by Surgery Service was performed and showed widespread necrosis. As a primary care provider, we should recognize TT as a possible cause of testicular pain using a diagnostic triad of history, examination and investigation. Calculation of TWIST score is useful to avoid unnecessary diagnostics and to have a prompt urology/surgery referral when suspected. This case also highlights an important message on awareness among transgender individuals who does tucking, that it can cause infertility and will limit their chances to have a biological child in the future. Patients should make good decisions, twists and turns are inevitable but if you don’t design your own life plan, chances are you fall into someone else’s plan.
Testicular Torsion; Scrotal Pain; Trans woman; Tucking; Cross - Dress
Debarbo CJM. Rare Cause of Testicular Torsion in a Trans Woman: A Case Report. Int J Fam Med Prim Care. 2020; 1(4): 1018.