testicular and ovarian torsion

Question 1

define testicular torsion

Answer 1

twist of spermatic cord-> testicular ischaemia and necrosis

peak incidence 13-15 years

Question 2

syx of testicular torsion 2

Answer 2

pain -severe and sudden
-can be referred to lower abdo

N+V

Question 3

features on examination of testicular torsion 3

Answer 3

swollen, tender testis retracted upwards
-skin may be reddened

cremasteric reflex is lost
-Stroking of the skin causes the cremaster muscle to contract and pull up the ipsilateral testicle toward the inguinal canal

elevation of testis does not ease pain
-prehns sign

Question 4

management of testicular torsion

Answer 4

urgent surgical exploration
-if a torted testis is found then both testis should be fixed as the condtion of bell clapper testis is often bilateral

Question 5

define ovarian torsion

Answer 5

partial or complete torsion of the ovrary and its supporting ligaments that may compormise the blood supplie

if falopian tube is involved this referred to as adnexal torsion

Question 6

risk factors for ovarian torsion 4

Answer 6

ovarian mass- present in around 90% of cases of torsion

-being of reproductive age

preganacy

ovarian hyperstimulatoin syndrome

Question 7

features of ovarian torsion

Answer 7

sudden onset of deep seated colicky abdo pain

associated with vomiting and distress

fever may be seen in minority (possibly swcondary to adnexal necrosis)

vaginal examination may reveal adnexial tenderness

Question 8

investgation of ovarian torsion and whats seen 1

Answer 8

ultrasound
-may show free fluid or a whirlpool sign