Testicular necrosis: a rare complication of poorly controlled diabetes mellitus

Abstract

A case presented here depicting testicular necrosis in a 45 years old male patient with diabetes mellitus. Past history suggestive of diabetes with very irregular medication. Patient presented with gradually increasing right testicular enlargement for three weeks. Ultrasonography showed abscess formation with no vascularity in right testis. Right orchiectomy done. Histopathology report confirmed testicular necrosis. Testicular necrosis is a common complication after torsion which leads to orchiectomy. In those cases, patients present with acute onset pain in the scrotum, usually unilateral. On examination there is acutely tender testis with red and angry looking overlying skin. In diabetic patients, urinary tract infections are common occurrence as well as epididymo-orchitis. Patients present with testicular pain with fever, leucocytosis etc. But testicular necrosis is extremely rare. Long term complications specific to diabetes mellitus include retinopathy, nephropathy and neuropathy. Patients with all forms of diabetes of sufficient duration, including insulin-dependent diabetes mellitus and non-insulin-dependent diabetes mellitus, are vulnerable to these complications, which cause serious morbidity. Testicular necrosis is a very rare complication of diabetes mellitus. An internet search did not reveal any article of testicular necrosis as a complication of diabetes. A case of unilateral testicular necrosis as a complication of diabetes mellitus is presented here for the first time. Probably accelerated microangiopathy along with poor control of blood glucose led to this unique complication.