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Z Year3 Urology > Testicular Torsion > Flashcards

Testicular Torsion Flashcards

1
Q

What are the two painful scrotal mass conditions?

A
  1. Testicular tosion

2. Epidiymitis and orchitis

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2
Q

What are non-painful scrotal mass presentations?

A
  1. Testicular cancer
  2. Variocele
  3. Hydrocele
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3
Q

What is testicular torsion?

A

twisting of the spermatic cord resulting in constriction of vascular supply and ischemia of testicular tissue

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4
Q

What is the urgency of testicular torsion?

A

surgical emergency

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5
Q

What are the two types of testicular torsion and which is more common?

A
  1. Intravaginal most common

2. Extravaginal (neonates)

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6
Q

What happens in intravaginal testicular torsion?

A

Twisting WITHIN the tunica vaginalis

Most common cause of acute scrotal pain in 10-18 yr olds

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7
Q

What happens in extravaginal testicular torsion?

A

Entire testis and tunica vaginalis twists

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8
Q

What is the mechanism for testicular torsion?

A

Due to incomplete fixation of the gubernaculum, which fixes the bottom of the testes to the scrotal wall allowing free rotation

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9
Q

What are RF for testicular torsion?

A
  1. Age under 25 years

2. Bell clapper deformity (90%)

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10
Q

What is bell clapper deformity?

A

deformity allowing testicles to rotate freely within the tunica vaginalis

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11
Q

How responsible is bell clapper deformity for testicular torsion?

A

accounts for 90% of cases of INTRAVAGINAL torsion

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12
Q

What are symptoms of testicular torsion?

A
  1. SYMPTOMATIC
  2. Painful
  3. Swollen, hot, tender erythematous scrotum
  4. Unilateral
  5. High riding testicle (affected one)
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13
Q

What reflex is ABSENT in testicular torsion?

A

cremasteric

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14
Q

What is the cremasteric reflex?

A

stroking/pinch of the inner thigh will cause the ipsilateral testicle to elevate via contraction of the muscle

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15
Q

What is the 1st line investigation for testicular torsion?

A

emergency exploration of the scrotum within 6 hours of symptom onset
DO NOT DELAY SURGERY FOR Doppler USS

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16
Q

What do you do after the testicle is twisted back?

A

bilateral orchidopexy is performed

17
Q

What is the 2nd line treatment for testicular torsion?

A

Manual de-torsion if surgery not available in 6 hours

18
Q

What would the doppler US show for testicular torsion?

A

show Whirlpool signs

19
Q

How quickly should treatment be put in place?

A

must be done within 6 hours on symptom onset to save the testis!

Z Year3 Urology (18 decks)

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