Testicular torsion

Question 1

Testicular torsion?

Answer 1

A surgical emergency. Twisting or torsion of the spermatic cord results, initially, in venous outflow obstruction from the testicle, progressing to arterial occlusion and testicular infarction if not corrected

Question 2

Testicular torsion aetiology?

Answer 2

Intraviginal (spermatic cord twists within the tunica vaginalis), extravaginal (usually in neonates, entire testis and tunica vaginalis twist in vertical axis on the spermatic cord)

Question 3

Testicular torsion risk factors?

Answer 3

imperfectly descended testes, high investment of the tunica vignalis.

Question 4

Testicular torsion epidemiology?

Answer 4

most common cause of acute scrotal pain in 10-18yrs.

Question 5

Testicular torsion symptoms?

Answer 5

sudden onset severe hemiscrotal pain, abdo pain, nausea and vomiting.

Question 6

Testicular torsion signs?

Answer 6

swollen, erythematous scrotum on affected side, swollen testicle will lie slightly higher than unaffected one, thickened cord. This may also be epididymo-orchitis or incarcerated inguinal hernia

Question 7

Testicular torsion investigations?

Answer 7

Dopple/duplex imaging of the testes will show reduced arterial inflow in testicular torsion and increased in epididymo-orchitis.

Question 8

Testicular torsion management?

Answer 8

Exploration of scrotum within 6 hr of pain, after twisting back, a bilateral orchidopexy sutures testicles to scrotal tissue to prevent recurrence.

Question 9

Testicular torsion complications?

Answer 9

Testicular infarction, atrophy, infection and impaired fertility.