Retractile testis is considered as a normal variant, where the cause for retraction is an overactive cremasteric
Because his history and absent cremasteric
reflex strongly suggested testicular torsion, ultrasonography was waived, and he was taken to the operating suite.
The testis has three fold vascular supplies, the testicular artery, artery of the vas and cremasteric
The scrotal wall consists of the following layers (from superficial to deep): skin, superficial fascia, dartos muscle, external spermatic fascia, cremasteric
fascia, and internal spermatic fascia.
It has been opined that injury to testicular artery has limited clinical significance in varicocelectomy as testis is supplied by three sets of arteries (testicular, cremasteric
, and vasal).
Abdominal reflex, cremasteric
reflex, tendon reflexes disappeared bilaterally.
The etiology of prenatal testicular torsion has not been elucidated fully, but difficult delivery, breech presentation, large baby, hyperactive cremasteric
reflex and multiple pregnancy have been reported to be predisposing factors (3).
Similarly, the intravenous application of heparin inhibited the negative effects of ischemia/reperfusion which were determined by intravital-microscopy in mouse cremasteric
microvessels as the macromolecule exclusion and intracapillary distribution of red blood cells .
(1,2) Patients most commonly present with testicular pain, a high-riding testicle with a possible horizontal lie, and an absent cremasteric
reflex on the affected side.
Lower abdominal and cremasteric
reflexes were lost and plantar reflexes were bilaterally extensor.
The testes may also be high riding due to the absence of the cremasteric
reflex (Davenport, 1996; Kadish and Bolte, 1998).
The arterial blood supply of the testis comes also from the artery of the ductus deferens and the cremasteric
artery, which anastomose with the testicular artery .