testicular torsion


Also found in: Dictionary, Thesaurus, Legal, Encyclopedia, Wikipedia.
Related to testicular torsion: testicular cancer, Testicular pain, Testicular self exam

Testicular Torsion

 

Definition

Testicular torsion is the twisting of a testis (testicle) on its connection.

Description

The testes are suspended in the scrotum by a single bundle of tissues that also carries the blood supply to and from the testes. If the testicle rotates, the bundle kinks, and the blood supply is shut off. The resulting situation is an emergency because the testis will die within hours if the blood supply is not restored.

Causes and symptoms

Some testes hang in such a way that they twist more easily than others. Nearly all torsions happen to adolescent males—between the ages of 12 and 18—because their testes enlarge by a factor of five to six during puberty. A larger testis is more likely to twist. Torsion can also occur in a newborn.
Symptoms of testicular torsion are sudden severe pain in the scrotum, swelling, nausea and vomiting.
A rare condition, testicular torsion occurs when the spermatic cord is twisted and cuts off the blood supply to the testicle.
A rare condition, testicular torsion occurs when the spermatic cord is twisted and cuts off the blood supply to the testicle.
(Illustration by Argosy Inc.)

Diagnosis

A nuclear scan of the scrotum may be performed. In this procedure, a tiny amount of radioactive fluid is injected into the blood and detected as it flows through the scrotum and testicles. Torsion is indicated if the radioactive fluid does not flow through the sore testis. Ultrasound scan accompanied by a contrast agent can also be used to diagnose testicular torsion.

Treatment

Surgery must be performed within 24 hours to ensure the health of the affected testis. During the procedure, the surgeon untwists the cord and secures the testis in place so that it cannot rotate again. The other testicle should also be secured to deter future testicular torsion. This procedure is called orchiopexy.

Prognosis

If the torsion is relieved within 24 hours, the testis will recover normal blood flow and function.

Prevention

Torsion of the unaffected testis is prevented by securing it during the surgery to correct the twisted testis.

Resources

Books

Walsh, Patrick C., et al., editors. Campbell's Urology. Philadelphia: W. B. Saunders Co., 1998.

Key terms

Orchiopexy — The surgical securing of the testis to prevent torsion.
Scrotum — The bag of skin below the penis that contains the testes.

testicular torsion

Torsion of testes Urology Twisting of the spermatic cord, with ↓ blood supply to the testes and scrotum; it is the most common cause of scrotal pain in boys, most of whom are < age 6, ±linked to ↓ connective tissue in the scrotum, trauma, or physical activity

testicular torsion

A urological emergency in which the testis is starved of its blood supply as it twists on the spermatic cord. The condition causes unilateral scrotal pain, often accompanied by nausea and vomiting, and typically occurs in young boys or adolescents. A characteristic physical finding is loss of the cremasteric reflex on the affected side. Treatment is a prompt operation to relieve the twisting of the cord. A delay in surgery beyond 6 hr rapidly increases the likelihood that the testicle will be lost.
See also: torsion
References in periodicals archive ?
(1) The supernumerary testis is typically identified subsequent to symptomatic presentation of inguinal hernia, maldescended testis, testicular torsion, hydrocele, or varicocele.
To assess factors that help to distinguish between genital/paragenital infection and testicular torsion, simple and multiple binary logistic regression analyses were performed on the different laboratory parameters (CRP </> 3 ml/L, WBC </> 10.4 g/L, </> 4 WBC per field in urine, </> 4 Ec per field in urine), time between onset of pain and arrival in the ED, characteristics of pain, localization of pain, and Prehn's sign (positive or negative).
Weidner, "Detection of normal intratesticular perfusion using color coded duplex sonography obviates need for scrotal exploration in patients with suspected testicular torsion," Journal of Urology, vol.
In case of an incarcerated inguinal hernia, testicular ischemia occurs owing to a compressed spermatic cord by the hernia sac and not by a twisted spermatic cord, as observed in testicular torsion. Mechanical venous obstruction occurs owing to a compressed cord by a hernia, leading to the swelling of the cord from the internal inguinal ring outward toward the testis.
Raphael was quickly triaged in the ED and admitted with a possible testicular torsion. Because his history and absent cremasteric reflex strongly suggested testicular torsion, ultrasonography was waived, and he was taken to the operating suite.
The diagnostic value of plasma SCUBE1, a novel biomarker of platelet activation, in Testicular Torsion: A Randomized, Controlled, Experimental Study.
The only known anatomic risk factor for intravaginal testicular torsion is the bell clapper deformity (Caesar & Kaplan, 1994; DaJusta et al., 2013).
In conclusion, this case report demonstrates that the monitoring of preoperative external detorsion of the spermatic cord with DWI could be a useful and valuable method in patients with acute testicular torsion. However, large sample studies are required to provide precise clarification and conclusions for this issue.
Epididymo-orchitis and testicular torsion are both accompanied by acute scrotal pain or swelling of the scrotum.
Testicular torsion is a common urologic emergency that usually affects male newborns, children, and adolescents.
Undescended testis and testicular torsion. Surgical Clin North Am 1985;65(5):1303-29.