Testicular torsion Flashcards
What is testicular torsion?
spermatic cord twists within the tunica vaginalis, compromising the blood supply
Is testicular torsion an emergency and why?
Yes because without treatment the testicle will infarct within a few hours
How does testicular occur?
Mobile testes rotate on the spermatic cord, this causes reduced arterial blood flow, impaired venous return and venous congestion, which leads to oedema and infarction to the testis
What deformity makes men more prone to testicular torsion?
Bell clapper deformity- a horizontal lie, and lack a normal attachment to the tunica vaginalis and so is more mobile and prone to twisting on cord structures
Why are neonates likely to get testicular torsion?
the attachment between the scrotum and tunica vaginalis is not fully formed and so the entire testis and tunica vaginalis can tort- extra vaginal torsion, t
What are the risk factors for testicular torsion?
age, previous testicular torsion, family history of testicular torsion and undescended testes
What are the clinical features of testicular torsion?
Sudden onset severe unilateral testicular pain with nausea and vomiting due to the pain, may have some abdominal pain
On examination of testicular torsion, where are the testis positioned and how will they be?
Higher compared to the other side with a horizontal lie, they will also be swollen and red
In testicular torsion what reflex is absent?
Cremesteric reflex
In testicular torsion will Prehns sign be positive or negative?
Negative- pain will not stop on elevation
What are the differential diagnosis for testicular torsion?
epididymo-orchitis, trauma, incarcerated inguinal hernia, malignancy, renal colic, hydrocoele, idiopathic scrotal oedema, torsion of hydride morgagni
What is torsion of the hydatid of Morgagni?
remnant of the mullerian duct, common testicular appendage that may become sorted and has similar sudden onset pain- may have a blue dot sign
How is testicular torsion diagnosed?
Clinical diagnosis, will explore the testis, can do a doppler ultrasound to investigate compromised blood flow, urine dipstick may be done to check for infective cause
What is the management for testicular torsion?
surgical emergency that has a 4-6hour window to salvage the testis before significant ischaemic damage occurs, analgesia and anti-emetics
What is the name for testicular torsion surgery?
Bilateral orchidopexy, unless non-viable in which case orchidectomy may be needed
