Testicular torsion

Question 1

What are the typical symptoms of testicular torsion?

Answer 1

Sudden onset pain in 1 testis
Uncomfortable walking
Pain in abdomen
N&V

Question 2

What are the signs of testicular torsion?

Answer 2

Inflammation of 1 testicle
Tender, hot and swollen
Testis may lie high and transversely

Question 3

When is testicular torsion most common?

Answer 3

Between ages 11-30

Question 4

What is intermittent torsion of the testis and how should it be treated?

Answer 4

Pain may have passed at presentation as torsion not active, but prophylactic fixing may be needed if pain was severe and lie is horizontal

Question 5

What is the DDx of testicular torsion?

Answer 5

Epididymo-orchitis
Tumour
Trauma
Acute hydrocele
Torsion of Hydratid Morgagni
Idiopathic scrotal oedema

Question 6

What investigations are used in testicular torsion?

Answer 6

Doppler USS
Isotope scanning
Surgical exploration

Question 7

What is the treatment for testicular torsion?

Answer 7

Possible orchidectomy (removal) and bilateral fixing
At surgery untwist and expose testis - if viable and good colour, fix both testes and return to scrotum
If poor colour and looks not viable - remove