Torsion of testes Flashcards
What is testicular torsion?
Twisting of spermatic cord with rotation of the testicle
Urological emergency
Typically teenage boy
What can testicular torsion lead to
Ischaemia -> necrosis -> sub or infertility
What can cause testicular torsion
Triggereed by activity eg sports
Bell clapper deformity
How does testicular torsion present?
Acute rapid onset of unilateral testicular pain
Ass with abdominal pain and vomitting
Examination findings are:
Firm swollen testicle
Elevated retracted testicle
Absent cremasteric reflex
Abnormal testicular lie - often horizontal
Rotation = epididymis not in normal position
What is bell clapper deformity?
Fixation between testicle and tunica vaginalis is absent - hangs horizontally and can rotate within tunica vaginalis, twisting spermatic cord -> testicular torsion
Where is the fixation between the testicle and tunica vaginalis
Posteriorly
Management of testicular torsion
- Nil by mouth, in preparation for surgery
- Analgesia as required
- Urgent senior urology assessment
- Surgical exploration of the scrotum
- Orchiopexy (correcting the position of the testicles and fixing them in place)
- Orchidectomy (removing the testicle) if the surgery is delayed or there is necrosis
How to confirm diagnosis testicular torsion?
Scrotal US
Not if will delay going to theatre
What see on scrotal US in testicular torsion?
Whirlpool sign - spiral appearance to spermatic cord and blood vessels
