Noida, May 14: Kailash Hospital treated a very rare and serious case of testicular torsion in a 15-year-old boy with Duchenne Muscular Dystrophy (DMD), a genetic condition that causes progressive muscle weakness. In this emergency, the testicle twists and cuts off its own blood supply, so quick treatment is essential. The case underscores the importance of rapid diagnosis, advanced imaging, and multidisciplinary surgical care in high-risk patients.
Testicular torsion is caused by twisting of the spermatic cord, which blocks blood flow to the testis and can lead to irreversible damage if not treated quickly. While it is most common in adolescents, its occurrence in patients with DMD is exceptionally rare, making this case especially significant. In rare and severe situations, torsion can affect both testicles (bilateral torsion), which may require removal of both if blood supply is not restored in time, leading to more serious long-term implications.
The patient presented with sudden, severe right-sided scrotal pain, localized swelling, and tenderness, with a history of mild, poorly localized pain for nearly 2–3 days before the acute worsening. Because of his underlying DMD, the patient faced difficulty in clearly expressing and localizing the pain, making clinical assessment more challenging.
Given the urgent nature of the symptoms, the medical team immediately performed a Colour Doppler Ultrasound, which revealed the absence of blood flow in the right testis, confirming acute testicular torsion. The contralateral testis showed normal vascularity.
Following the diagnosis, the patient was taken up for emergency surgical exploration. Intraoperatively, doctors found a 720-degree torsion of the spermatic cord, and the affected testis was found to be non-viable due to prolonged ischemia (a long period of poor blood flow), the testicle could not be saved, so orchiectomy (surgical removal of the testicle) was done. To prevent future torsion (twisting again), contralateral orchidopexy (fixing the other testicle in place) was also done during the same surgery.
Special anaesthetic precautions were taken in view of the patient’s DMD, including continuous cardiac and respiratory monitoring throughout the procedure and postoperative period. The patient recovered well after surgery, remained hemodynamically stable, and was discharged after a short hospital stay of about 2 days.
Dr. Rahul Tiwari, Consultant Uro Surgeon, Kailash Hospital & Neuro Institute, said, “This case is a reminder that testicular torsion is a surgical emergency where every minute matters. In patients with Duchenne Muscular Dystrophy, diagnosis can be even more difficult due to communication and mobility limitations. Early suspicion, prompt imaging, and timely surgery were key to the successful management of this rare case. This is believed to be the first reported case of testicular torsion in an adolescent patient with Duchenne Muscular Dystrophy (DMD) in the world.”
The patient is currently stable, with no postoperative complications and preserved function of the remaining testis. Ongoing monitoring for cardiac and respiratory health remains important as part of long-term care for DMD. However, long-term follow-up is essential, as potential future complications may include reduced fertility, hormonal imbalance if the remaining testis is affected, and psychological impact, especially in adolescent patients.
Kailash Hospital is committed to delivering advanced, patient-centred care through timely diagnosis, expert intervention, and a multidisciplinary approach to complex medical and surgical cases.