Testicular Torsion

Question 1

Testicular torsion relates to twisting of what?

1 - vas deferences
2 - spermatic cord
3 - epididymis
4 - seminal vesicle

Answer 1

2 - spermatic cord

The testicle is also twisted

Question 2

What is the incidence of testicular torsion?

1 - 1 : 100,000
2 - 100 : 100,000
3 - 1000 : 100,000
4 - 10,000 : 100,000

Answer 2

2 - 100 : 100,000

Question 3

What age does testicular torsion most commonly occur?

1 - 1-10
2 - 15-25
3 - 30-40
4 - >65

Answer 3

2 - 15-25

Most common in teenage boys, BUT can occur at any age

Question 4

Is testicular torsion dangerous?

Answer 4

• Yes

Urological emergency, can lead to ischaemia and necrosis of the testicle, subfertility or even infertility

Question 5

Although not always, what is often the trigger for testicular torsion?

1 - constipation
2 - UTI
3 - physical activity
4 - appendicitis

Answer 5

3 - physical activity

Question 6

Which of the following is NOT a typical clinical symptoms of testicular torsion?

1 - acute onset unilateral testicular pain
2 - abdominal pain
3 - haemoptysis
4 - nausea and vomiting

Answer 6

3 - haemoptysis

Often pain is the only symptom

Question 7

All of the following may present when examining the testicle in a patient with suspected testicular torsion, EXCEPT which one?

1 - Non-tender swollen testicle
2 - Elevated (retracted) testicle
3 - Absent cremasteric reflex
4 - Abnormal testicular lie (often horizontal)
5 - Rotation, so that epididymis is not in normal posterior position

Answer 7

1 - Non-tender swollen testicle

Typically swollen, hard and tender

Question 8

Although not the only cause, a bell clapper deformity can cause testicular torsion.

Question 9

What imaging can be used to confirm a diagnosis of testicular torsion?

1 - cystoscopy
2 - ultrasound
3 - MRI
4 - X-ray

Answer 9

2 - ultrasound

Can show the whirlpool sign

Assessments that delay treatment is NOT recommended

Question 10

If we suspect testicular torsion, which of the following should be conducted?

1 - consult senior urologist
2 - nill-by-mouth in case surgery required
3 - analgesia
4 - surgical exploration
5 - all of the above

Answer 10

5 - all of the above

Question 11

What is the definitive treatment for testicular torsion?

1 - cystoscopy
2 - fluid restriction and gas through urethra
3 - surgery
4 - wait and see

Answer 11

3 - surgery

Can be:
- orchidectomy (removal)
- orchiopexy (fixation of testicles)