Testicular Torsion

Question 1

What is testicular torsion?

Answer 1

Testis tires on the spermatic cord, potentially producing ischemia from reduced arterial inflow and venous outflow obstruction

Question 2

How quickly should you diagnose and treat testicular torsion to prevent testis loss?

Answer 2

6hrs

It is more common in the left side

Tends to occur more in young men

Question 3

What are the signs and symptoms of testicular torsion?

Answer 3

Acute scrotal pain following vigorous physical activity
Profound tenderness and swelling
Nausea and vomiting

Question 4

What reflex will be absent in torsion?

Answer 4

Cremasteric reflex

Question 5

What imaging can be used ?

Answer 5

Scrotal ultrasound with color will show diminished blood flow

Question 6

How do you treat testicular torsion?

Answer 6

Manual detorsion “opening the book”
Performed by grasping the testicle and rotating it within the scrotum outward one to two full 360 degree turns
Prompt relief of pain
If there is no relief rotate the testicle in the opposite direction

Surgical exploration and detorsion regardless of manual attempt