Testicular Torsion****

Question 1

What is it?

What age is it common?

Answer 1

Twisting of the spermatic cord causing testicular ischaemia

Age 13

Question 2

What testicular pathology is a risk factor?

Answer 2

Undescended testes

Question 3

Symptoms:

Pain in one teste - what does this make it difficult to do?

Other symptoms to expect with someone in pain?

Pain may be intermittent

Answer 3

Uncomfortable to walk

N&V and Abdo pain

Question 4

Signs:

One testis is swollen, red and tender.

How does the teste tend to sit in the scrotum?

There is an absent cremasteric reflex. What is it?

Answer 4

Tends to sit higher and more transverse

The cremasteric reflex is a superficial reflex found in human males that is elicited when the inner part of the thigh is stroked. Stroking of the skin causes the cremaster muscle to contract and pull up the ipsilateral testicle toward the inguinal canal.

Question 5

Investigations:

What scan is used to look at the testes themselves?

What is used to check blood flow?

Answer 5

Duplex USS

Doppler scan

Question 6

Management:

Orchidopexy is done.

• What is it
• Why is it done on both sides?

Answer 6

Detorsion and fixation with suture

Other side at increased risk of torsion