Testicular torsion

Question 1

Definition of testicular torsion

Answer 1

• Torsion of the spermatic cord, compromising testicular blood flow

Question 2

Presentation

Answer 2

*Acute swelling of the scrotum indicates testicular torsion until proven otherwise*

• History
  
  • Sudden, severe pain in one testis
  • May be lower abdominal pain
  • Nausea & vomiting
• Examination
  
  • Scrotal erythema
  • Swollen, tender testis retracted up
  • Lifting the testis up increases pain (relieves in epididymitis)

Question 3

Investigations for testicular torsion

Answer 3

• Clinical diagnosis
• Colour doppler ultrasound

Question 4

Management of testicular torsion

Answer 4

• Manual reduction of torsion
• Orchidopexy (if viable, retorsion and fixing of the testis in the scrotum)
• Orchiectomy (if non-viable)