Testicular Torsion Flashcards
Testicular Torsion tends to occur in young men and is rare in men older than ___ years
30
Testicular Torsion
Usually rotates what direction?
medially
Testicular Torsion happens more on what side do to what?
Left side because of the longer spermatic cord
Urgency to diagnose and treat testicular torsion within how many hours to prevent loss of the testis?
6 hours
S/s of what?
(1) Acute scrotal pain
(a) Often occur several hours after vigorous physical activity or minor trauma to the testicles
(2) Profound tenderness and swelling
(3) Nausea and vomiting
(4) Negative cremasteric reflex
(a) Due to impingement of cremasteric muscle and nerve
(5) Bell clapper deformity
(a) High-riding testis oriented transversely
Testicular torsion
Imaging for testicular torsion
Scrotal Ultrasound (with color flow Doppler) -assessing for absent or diminished blood flow in testicular torsion
Treatment
(1) Manual detorsion (“opening a book”)
(2) Surgical exploration and detorsion
- –Regardless of result of manual detorsion
How do you preform manual retorsion?
Performed by grasping the testicle and rotating it within the scrotum outward (medial to lateral) one to two full 360 degree turns.
Post manual detorsion
Prompt relief of pain, lower position of the testis in the scrotum, and return of arterial flow on Doppler ultrasound suggests what?
detorsion.
Complications of testicular tortion
(1) Orchiectomy
(2) Testicular atrophy
(3) Infertility - Due to abnormal spermatogenesis
Testicular salvage drops from 80-100% at ____hours to nearly 0% by ___ hours
6-8 hours
12 hours
Testicular torsion Disposition
1) MEDEVAC
(2) As dictated by Urology
What is Bell clapper deformity?
High-riding testis oriented transversely
