Testicular torsion

Question 1

What is testicular torsion?

Answer 1

A urological emergency where the spermatic cord is twisted, which can result in ischaemia and necrosis

Question 2

What is the presentation of testicular torsion?

Answer 2

Sudden onset of severe, unilateral pain
Pain may be referred to lower abdomen
Nausea and vomiting

Question 3

What are the examination findings in testicular torsion?

Answer 3

Loss of cremasteric reflex
Firm, swollen testicle
Elevated testicle
Abnormal testicular lie

Question 4

What is a Bell-Clapper deformity?

Answer 4

Fixation between the testicle and tunica vaginalis is absent

There is increased risk of the testicle rotating within the tunica vaginalis, causing testicular torsion

Question 5

What is the management of testicular torsion?

Answer 5

Urgent surgical exploration
Nil by mouth (preparation for surgery)
Analgesia
Orchioplexy
Orchidectomy

Question 6

What investigation can be used to confirm testicular torsion?

Answer 6

Scrotal ultrasound

Question 7

What will be seen on scrotal ultrasound in testicular torsion?

Answer 7

Whirlpool sign