Testicular Torsion Flashcards
What is a testicular torsion?
Twisting of the testicle, causing ischemia
Risk factors for testicular torsion?
Undescended testis (cryptorchidism)
“Bell clapper” deformity
Typical presentation of testicular torsion?
age 12-18 y/o
acute onset of severe pain
no swelling
PE findings in testicular torsion?
tender, firm testis
high riding testis
Horizontal lie
Absent cremasteric reflex
No pain relief with elevation
Thick/knotted sperm cord
Epididymis not posterior to testis
How can we dx testicular torsion?
clinically!
doppler US
nuclear testicular scan
What will you see on doppler US for testicular torsion?
What about for acute epididymitis/orchitis?
decreased blood flow
increased blood flow
What would you see on nuclear testicular scan for testicular torsion?
What about for acute epididymitis/orchitis?
decreased radiotracer activity
increased radiotracer activity
Tx for testicular torsion?
surgical exploration –> no NOT delay surg for imaging
manual detorsion “open the book”
What can you do to make a pt more comfortable prior to surg?
manual detorsion
“open the book”, twist in the opposite way of the torsion
(this is a temporary fix)
Surgery for testicular torsion…
Testis is detorsed
- if testis is viable > orchiopexy of both sides
- if not viable > orchiectomy, orchiopexy of contralateral testis
Time period for viable testis? non-viable after..?
<6 hours
> 24 hours
