"I get all tingly at football games"

mycrofft

Still crazy but elsewhere
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You are working first aid at the concessions area of a highschool football game. A middle-aged man walks up looking very worried and worriedly announces "Something's wrong with my crotch!".

He doesn't appear inebriated, his gait is mostly normal, no visible signs of injury. He describes both "a numbness" and "tingling" of his left scrotum, a small area of the antero-proximal-medial thigh, and the left half of his penis. No pain or tenderness .Onset was gradual over about two minutes, and a hasty look under the pantsband reveals nothing visibly wrong. His wife pulls up the car, he gets up off a chair with a grunt and goes with her to the hospital.

Two weeks later you see him at the grocery store, he says he's fine but he won't be at the football games anymore.

VS normal, on meds for BP (metoprolol) and has large bottle of naproxen in his grocery cart.

What happened?
 

46Young

Level 25 EMS Wizard
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L5/S1 herniation?
 

46Young

Level 25 EMS Wizard
3,063
90
48
Pudenal neualgia?
 

JPINFV

Gadfly
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Some sort of nerve impingement (slipped disk, spinal stenosis, etc).

Now what if he complained of bilateral numbness to his crotch, urinary retention, and trouble walking?
 
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mycrofft

mycrofft

Still crazy but elsewhere
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46/young gets it on second try. Based on true case. The deciders are the localization and unilaterality of complaint with lack of affect of gait or visible deformity, and absence of perceived initiating event.

Sitting on a hard surface and twisting once in a while. Grind that nerve. Pt fully recovered in two weeks.

JPINV, yes, a whole different game. Expand?

Even unilateral pain in that part of the thigh WITHOUT unilateral pudendal nerve complaint would be another can of worms.
 

JPINFV

Gadfly
12,681
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JPINV, yes, a whole different game. Expand?
Saddle numbness (perineal numbness), loss of bowel and bladder function (retention or incontinence), and leg weakness/paralysis is the classic triad for cauda equina syndrome. Cauda equina syndrome is compression of the cauda equina (we're simple people when it comes to naming things) and is a surgical emergency.
 

NomadicMedic

I know a guy who knows a guy.
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It's a common complaint among long distance cyclists. The majority of the issues can be fixed with saddle angle or position adjustments. As a former long distance biker, I can tell you, it's an unpleasant experience. :)
 
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OP
mycrofft

mycrofft

Still crazy but elsewhere
11,322
48
48
OP
OP
mycrofft

mycrofft

Still crazy but elsewhere
11,322
48
48
Saddle numbness (perineal numbness), loss of bowel and bladder function (retention or incontinence), and leg weakness/paralysis is the classic triad for cauda equina syndrome. Cauda equina syndrome is compression of the cauda equina (we're simple people when it comes to naming things) and is a surgical emergency.

Thanks!
 
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OP
mycrofft

mycrofft

Still crazy but elsewhere
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Never one to shrink from taking a thread sidewise, and not from personal experience as a patient, scabies is harder to cure.
 
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OP
mycrofft

mycrofft

Still crazy but elsewhere
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I had a topic?:unsure:
 
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