Torsion and undescended testicles

Question 1

what is another name for undescended testes?

what pathway do testes usually take and when?

Answer 1

• crytorchidism

- descend from the intra-abdominal position through the processes vaginalis into the scrotum at 7th month gestation

Question 2

what should you suspect if you have bilateral undescended testicles?

what is an ectopic testes?

Answer 2

• hypopituitarism

- descended into the wrong place e.g. groin

Question 3

who is more likely to get undescended testes?

Answer 3

• premature babies, often accompanied with inguinal hernias

Question 4

what is the management?

what is the risk if surgery not performed?

Answer 4

• orchidopexy before age 2
• malignancy
• infertility

Question 5

When does testicular torsion commonly occur?

why?

Answer 5

• below age 6

- unusually mobile, testes rotate on the spermatic cord

Question 6

what clinical features do you get in torsion?

Answer 6

• acute pain and swelling of the scrotum

- tender and swollen scrotum

Question 7

when should surgery be performed?

what must also happen during surgery?

Answer 7

• within 6 hours, majority of gonads survive

- contralateral testis must also be fixed as it is prone to torsion