Testicular Torsion Flashcards
1
Q
ESSENCE
A
Twisting of spermatic cord with rotation of testicle
Urological emergency, delay in treatment risks ischaemia and necosis leading to infertility
2
Q
AETIOLOGY
A
- Bell clapper deformity (anatomical defect)
- Trauma, such as during sports
3
Q
EPIDEMIOLOGY
Age group
A
Teenage boys most common
4
Q
CLINICAL FEATURES
Presentation
A
- Acute rapid onset of unilateral testicular pain
- May be associated with abdominal pain and vomiting
5
Q
CLINICAL FEATURES
Signs
A
- Firm swollen testicle
- Elevated (retracted testicle)
- Absent cremasteric reflex
- Abnormal testicular lie (often horizontal)
- Rotation, epididymis not in normal posterior position
6
Q
What is Bell-Clapper deformity
A
Fixation between testicle and tunica vaginalis is absent
Testicle hangs in horizontal position instead of vertical. and able to rotate within tunica vaginalis, twisting spermatic cord
7
Q
INVESTIGATIONS
First choice
A
- None if it will delay going to theatre
- Scrotal US can confirm diagnosis
- Shows whirlpool sign
8
Q
MANAGEMENT
General principles
A
- Urological emergency
- Nil by mouth in prep for surgery
- Analgesia as required
- Urgent senior urological assessment
- Surgical exploration of scrotum
- Orchiopexy (correcting position of testicles and fixing them in place)
- Orchidectomy (removal of testicle)
