Testicular Torsion

Penis/Testes

Understanding Testicular Torsion: A Urological Emergency

Testicular torsion is a critical urological emergency that requires immediate diagnosis and intervention to prevent permanent damage to the testes. It is essential to recognise its symptoms and management strategies and seek timely treatment as most patients may be too young to express themselves correctly.

What Is Testicular Torsion?

Testicular torsion occurs when the spermatic cord twists, cutting off the main blood supply to the testis. This condition commonly affects adolescents or young children but can occur at any age. It is a medical emergency that necessitates immediate surgical intervention to save the affected testicle.

Symptoms of Testicular Torsion

Key symptoms include:

Severe scrotal pain: Sudden onset, often localised to one testis.
Scrotal swelling: Accompanied by redness or tenderness.
Nausea and vomiting: Common in younger patients.
Abnormal testicular positioning: Often elevated and horizontally oriented due to the twisted cord.

Early recognition of these symptoms is crucial for preserving testicular function.

If you think you may be presenting symptoms of Testicular Torsion, schedule a consult as soon as possible.

Diagnosis

Diagnosing testicular torsion involves:

Clinical assessment: A thorough physical examination focusing on scrotal pain and a timeline of events as the duration of torsion is crucial.
Ultrasound with Doppler imaging: Used to evaluate blood flow to the affected testis. Reduced or absent flow is a hallmark of torsion.
Differential diagnoses: Conditions like epididymitis, hydrocele, and inguinal hernia should be ruled out.

Management

Time is of the essence in managing testicular torsion. The goal is to restore blood flow to the testis within six hours to maximise salvage rates:

Surgical exploration

The definitive treatment involves untwisting the spermatic cord and assessing testicular viability.

Consent and communication

Clear communication with the patient and family about risks and outcomes is essential.

Prognosis and Long-Term Considerations

The prognosis depends on the timing of intervention:

Preventive Measures

While testicular torsion cannot always be prevented, individuals with a history of intermittent torsion or congenital abnormalities (e.g., bell clapper deformity) may benefit from elective orchidopexy.

Testicular torsion is a true medical emergency that highlights the importance of early recognition and treatment. If you or someone you know experiences sudden scrotal pain, seek immediate medical attention to ensure the best possible outcome.

If you think you may be presenting symptoms of Testicular Torsion, schedule a consult as soon as possible.