(U)- Testicular Torsion

Question 1

Who is typically affected by testicular torsion?

Answer 1

Teenage boy

Question 2

What is the most common cause of testicular torsion?

Answer 2

Activity such as sports

Question 3

How does testicular torsion present?

Answer 3

Rapid unilateral testicular pain

Abdominal pain (may be only symptom in boys)

Vomiting

Question 4

What are the examination findings of testicular torsion?

Answer 4

Firm swollen testicle

Elevated testicle

Absent cremasteric reflex

Abnormal testicular lie (horizontal)

Rotation (epididymis not in posterior postion)

Question 5

What is the bell-clapper deformity?

Answer 5

Fixation between testicle and tunica vaginalis is absent

Testicle hangs horizontally instead of vertically

Able to rotate within the tunica vaginalis, twisting at the spermatic cord, as it twists the blood supply is cut off

Question 6

How is testicular torsion managed?

Answer 6

Immediate surgical exploration of the scrotum

Orchiopexy
Correcting the position of the testicle and fixing in place

Orchidectomy
Removal of the testicle if there is necrosis

Question 7

If imaging is used what would a scrotal ultrasound show?

Answer 7

Whirlpool sign
Spiral appearance to spermatic cord and blood vessels