How is the egg pain in the middle of the night?

I often hear friends joking together that "idle eggs hurt". This is a joke, describing doing a boring and unreliable thing, or describing a very idle and boring state. In fact, there is indeed a boy's egg pain in real life, so what about the boy's egg pain in the middle of the night? Why do I have an egg ache in the middle of the night?

1, the cause of egg pain in the middle of the night

In network language, "egg pain" is often used to refer to all kinds of unreasonable things made because of being too bored, and also refers to the state of boredom. But in real life, if men really feel "egg pain", especially at night, it is not a boring trivial matter, and it may be "twisting eggs". A junior high school boy in Huadu District, Guangzhou was suddenly awakened by pain in the middle of the night and found that the scrotum of his lower body was swollen. His parents took him to a nearby clinic. He was diagnosed with orchitis, but he didn't get better after hanging up the needle for a few days. Until the fifth day of onset, I came to Hedong Branch of Guangzhou First People's Hospital. Color Doppler ultrasound examination showed that one of his testicles had been "freely rotating" in the scrotum for three weeks, and "the spermatic cord was twisted like a twist", which required immediate surgery. Unfortunately, during the operation, it was found that the twisted testis was black and necrotic due to the long blood circulation time. The "ball" is not guaranteed and needs to be removed.

Deng, chief physician of andrology, Hedong Branch of Guangzhou First People's Hospital, said that testicular torsion, pre-puberty and neonatal period are the peak periods of onset, and about half of them occur during sleep. Once testicular torsion happens, we must act immediately. After 10 hour reduction, the testis can survive and may not need surgery. However, if it is delayed for 24 hours and the best opportunity to defend the "testicles" is delayed, it is often necessary to surgically remove the twisted testicles immediately, otherwise the spermatogenic function of the other party may also be affected.

1, tall and thin boys tend to "twist eggs"

Deng introduced that in the scrotum, the position of the testis is not "fixed". There is a spermatic cord hanging from each side of the testis, which contains vas deferens, arteries and veins, nerves and muscles. It is the key channel to transport blood and nutrients to the testis. Testicles are like pendulums in scrotum, with a large amount of activity, so testicular torsion will occur in some cases.

About half of testicular torsion occurs during sleep. Testicular pain, who started out as a scrotum, later spread to the whole scrotum. It is persistent and the pain will suddenly increase. Especially when lying on your back, testicular lifting will aggravate local pain, and the pain will sometimes radiate to the groin and lower abdomen. Patients may also feel nausea and vomiting.

According to the literature, the oldest patient with testicular torsion is 68 years old, and the youngest is a newborn, but most of them are young people under 20 years old, accounting for about 80% of all cases. According to Deng's analysis, there are several possible reasons why testicular torsion mainly occurs in young men: during adolescence, reproductive organs need more nutrients, so blood circulation accelerates, leading to mild varicocele of spermatic vein and inducing testicular "rotation"; Adolescence is a time of learning stress and mental fatigue, and sleeping posture at night does not pay attention to testicular torsion; Sports-loving boys' excessive exercise makes their testicles excited and energetic. Tintin's erection suddenly pulls to his testicles when he sleeps at night, and improper masturbation or excessive masturbation leads to intense congestion and contraction of the levator testis.

According to Deng's experience, most boys with testicular torsion are thin and tall, which may be related to the length of their spermatic cord.

2, more than 24 hours "ball" is not guaranteed.

Testicular torsion is mostly unilateral, and the incidence on the left side is slightly higher than that on the right side, because men tend to have a slightly longer spermatic cord on the left side in physiological structure. Bilateral testicular torsion occurred in 2% cases, mostly in newborns or infants. The etiology remains to be confirmed, which is related to the incomplete closure of the tunica vaginalis around the testis of newborns. Deng said that the main manifestations of children's testicular torsion are crying and the scrotum on the twisted side is red and swollen, and the mass in the scrotum is even several times larger than the normal testis. Parents can observe that the swollen scrotum skin is red and thin, and once the disease occurs, it is easy to find. And because children have better compensatory ability, fewer patients need to have their testicles removed.

However, once adolescent boys get sick, the situation is more serious. "Generally speaking, early patients can be reset by hand, and the testicles can survive after being reset within 10 hours without serious adverse consequences. However, if the blood circulation cannot be restored because of testicular torsion, or the torsion time exceeds 24 hours, simple manual reduction will not work, and immediate surgery is needed, and it is very likely that the twisted testis will be removed. Otherwise, if the necrotic substance is not treated in time, it will be transmitted to another testis through the capillary network, and the remaining testis may also lose its spermatogenic function. " Unfortunately, Deng said, two or three patients with testicular torsion who were treated last year had been ill for more than a day when they came to see a doctor. There are also patients with spermatic cord wound three times, "twisted like a twist", testicular blood loss for too long, black and necrotic during surgery, and had to be removed.

3. It is easy to be misdiagnosed as orchitis

Deng said that testicular torsion is generally diagnosed by observing the blood supply of both testicles with color Doppler ultrasound. In basic hospitals with poor hardware and equipment, experienced doctors can also look for it by hand, because the ipsilateral spermatic cord will be shortened after testicular torsion, and the spermatic cord will be lifted up and basically not touched. However, some inexperienced doctors may be misdiagnosed as acute orchitis and acute epididymitis, and the "testis" has not been reset in time, which is an important reason for the delay in treatment of testicular torsion.

Deng introduced that although the pain is the same, because of inflammatory reaction, acute orchitis and acute epididymitis are often accompanied by fever, and the white blood cell index of blood routine is elevated, which may lead to abnormal urination; Testicular torsion generally has no symptoms of urinary system, urine test and white blood cell index in blood are normal, and there will be no fever in the early stage of the disease, and there may be fever in the later stage of necrosis.

2. Other factors causing egg pain

Some men are highly congested in genitals and gonads due to sexual excitement during sexual life, which leads to testicular pain after sexual life; In addition, ureteral calculi, cryptorchidism, testicular hyperplasia, testicular ischemic pain and other problems are also common causes of male "egg pain."

3. Relevant inspection

1, B-ultrasound of prostate, B-ultrasound of prostate is used to determine the shape, size and position of prostate, and can be used to diagnose diseases such as prostatic hyperplasia, prostate tumor, calculus and calcification, as well as prostate abscess, cyst and chronic prostatitis, and can also be used to detect the position of prostatic urethral alloy stent.

2, testicular self-examination, testicular self-examination function is used for the examination of testicular lesions.

3. Tiger red plate agglutination test is used to diagnose brucellosis.

4, semen volume, semen volume inspection can reflect fertility.

5, internal genital examination, the role of internal genital examination is to check prostate examination, seminal vesicle examination, testicles and so on.