16-Year-Old Loses Left Testicle Into Body While Picking Up Golf Ball

Was this a case of losing one ball while trying to pick up another? A case report just published in the journal Urology Case Reports described what happen to an otherwise healthy 16-year-old male when he leaned over trying to retrieve a golf ball. He suddenly developed pain in his lower left abdomen and then soon noticed that something was missing in his left groin area. Was it his keys? His wallet? No, it was his left testicle. And that’s the kind of thing that you can’t simply go to the golf course “Lost and Found” to relocate.

Yes, something nuts had happened. The left portion of his scrotum was left with no left testicle. This was a total scrotal change. His left testicle was presumably present and accounted for earlier that day. Granted, not everyone with testicles may do a scrotum inventory each and every morning and say, “Whew, still got balls.” But as is the case with either your significant other or cheese, you tend to notice fairly soon when one of your testicles goes missing.

Also, the guy didn’t recall suffering any type of trauma to his balls at any point that day. Trauma to your balls is something that you tend to notice and remember. Rarely, will you say, “Hmm, did I just get kicked in the balls? I can’t quite tell.” He wasn’t really exerting himself at the time his ball went a-missing, either. Golf is not exactly the most strenuous of sports, unless you happen to be mixing some mixed martial arts (MMA) with it.

Rather than asking around, “Have you seen my testicle,” or starting a “Go Find Me” page, the 16-year-old apparently recognized that such a situation called for immediate medical care. At the hospital, he underwent a CT that showed his left testicle to be in the wrong neighborhood. His left testicle had moved on up into his abdomen, higher than what’s called the internal inguinal ring. The patient continued to suffer mild abdominal pain along with nausea, which he would use over-the-counter pain relievers to control.

It turned out that the patient’s balls did in fact have an unusual travel history. That’s both the right and the left. Soon after his birth, it was noticed that his right testicle didn’t exactly come on down. Typically, when you are a fetus, your testicles first form in your abdomen. During your last couple months of squatting in your mother’s uterus, your testicles gradually descend from your abdomen through your groin via a tube-like structure in your groin called the inguinal canal, making their way down into their final destination: your scrotum. When your testicles don’t descend in this manner, they are called undescended testicles or cryptorchidism. This obviously has nothing to do with crypto currency, unless that’s what you are using to pay for your health insurance.

It’s important to mention something about the vaginal process here. In this situation, the vaginal process, otherwise known as the processus vaginalis, is not a fancy, non-romantic way of describing sexual intercourse as in, “It’s time for us to begin the vaginal process.” Instead, it is an outpouching of the abdominal wall that develops early on when you are fetus. In males, this outpouching normally gets obliterated. In females, the processus vaginalis, also known as the canal of Nuck, eventually becomes the round ligament of the uterus. When the processus vaginalis remains and you’re a male, it can make it more likely for one or more of your testicles to get trapped in your abdomen.

Having your balls remain in your abdomen may seem like a great way of protecting them from being kicked. But the insides of your abdomen are very warm, which can keep your balls way too toasty. As a result, this may damage your testicles and sperm, adversely affecting your fertility and making it more likely for tumors to grow. For example, the following graphic lists cryptorchidism as one of the risk factors for testicular cancer:

An undescended testicle can twist around in your body as well, resulting in testicular torsion, which is not a fun condition to have. Plus, you don’t want to keep explaining to any partners that you may have that you do, in fact, have balls.

Therefore, at 18 months of age, the patient had undergone a right orchiopexy, which was a surgical procedure to bring that ball right on down. He also already had a history of a retractile left testicle. This is when the testicle seems to be outside of the scrotum, which was confirmed during a pediatric urology examination when he was 11 years of age. In this case, outside the scrotum didn’t mean that the testicle was floating in the air or riding a bicycle. The testicle appeared to temporarily move back up into his groin. A retractile testicle is different from an undescended testicle, is considered to be normal, and normally doesn’t require treatment.

However, what the 16-year-old had noticed on the golf course was different from simply a retractile testicle. This was a tougher nut to crack, so to speak. His left testicle was way higher up in the body than it should have been. The docs at the first hospital apparently realized that they weren’t quite as on the ball about what to do about this situation and thus referred the patient to a pediatric urology clinic for further evaluation and management. This is presumably where the University of Utah authors of the case report (Jennison N. Cull, Deborah L. Jacobson, and Anthony J. Schaeffer) got involved. The pediatric urologists found the patient’s left groin to be tender and no left testicle to be found. Eventually, they took the teen to the operating room where they used a scope to look inside his abdomen. There they found the traveling left testicle in the patient’s abdomen. They also found a patent processus vaginalis, which meant that the vaginal process was still there.

The surgeons then tried to bring the left testicle back down through the inguinal canal into the scrotum. Now, you may consider having big balls to be a good thing. But, in this case, it was a bit of a problem. His left testicle was too large to go through his inguinal canal. Therefore, the surgeons had to do a fair amount of pushing and pulling before the ball dropped in place. The surgeons then repaired the patent processus vaginalis and used some stitches to anchor the left testicle to the scrotum, hoping that a stitch in time would save one, one testicle, from moving back up into the abdomen. The surgery ended up successfully resolving the issue without complications.

This was an unusual case of one losing oneself. Of course, you shouldn’t have to worry about your testicles moving back into your abdomen every time you lean over on the golf course or anywhere else for that matter. Such a “lean in” situation just ain’t that common. So, don’t use your testicles as an excuse to get others to pick up things for you by saying something like, “Can you help get that for me? I’d do it myself but, you know, my testicles.” In general, it’s not a great idea to lean on your testicles as an excuse. Otherwise, things could get a little nuts.