Testicular Torsion
Testicular torsion is a twisting of the testicles and the spermatic cord (the structure extending from the groin to the testes that contains nerves, ducts, and blood vessels). Torsions are sometimes called "winter syndrome". This is because they often happen in winter, when it is cold outside. The scrotum of a man who has been lying in a warm bed is relaxed.When he arises, his scrotum is exposed to the colder room air. If the spermatic cord is twisted while the scrotum is loose, the sudden contraction that results from the abrupt temperature change can trap the testicle in that position.The result is a testicular torsion. The torsion causes decreased blood flow to the testes, essentially strangling them of oxygen and nutrients.This is a painful problem that usually occurs in boys 10 years and older. While it generally occurs in adolescent boys, it may also occur during fetal development or shortly after a baby is born. Testicular torsion will result in the death of the testicle and surrounding tissues.
It is also believed that torsion occurring during fetal development can lead to the so-called neonatal torsion or vanishing testis , and is one of the causes of an infant being born with monorchism. In most males, the testicles are attached to the inner lining of the scrotum.Males whose attachment is higher up are at risk of testicular torsion. This condition is known as a bell clapper deformity (as in the central piece of a bell) and is a major cause of testicular torsion. A male who notices the ability of either or both testicles to freely rotate within the scrotum should be aware that he is at risk of testicular torsion. The problem is most likely during puberty, but can strike at any age. In most cases, only one testicle is involved, although both can be affected. If the situation isn't remedied within 24 hours, the testicle may be lost.
Causes of Testicular Torsion
Common causes of Testicular Torsion
- Strenuous exercise.
- Congenital spermatic cord disorder.
- Congenital testicle disorder.
- Bell clapper deformity.
- Sexual arousal.
- Trauma.
- Active cremasteric reflex.
- Inadequate.
- Bilateral.
Symptoms of Testicular Torsion
Common symptoms of Testicular Torsion
- Fever.
- Scrotal swelling.
- Nausea.
- Vomiting.
- Urinary frequency.
- Ipsilateral loss of the cremasteric reflex.
- Light-headedness.
- Red scrotum.
Treatment of Testicular Torsion
Common Treatment of Testicular Torsion
- Many pediatric urologists will therefore take a newborn to surgery within the first few hours or days of life to remove the affected testicle and to place sutures around the opposite testicle to prevent future torsion.
- Testicle surgery - to restore blood suppy to the testicle
- Surgical anchoring of spermatic cord
- Testicle removal - if the testicle is damaged beyond repair from lack of blood supply
- Mild analgesic pain relief can be administered once testicular torsion has been diagnosed or while awaiting further studies.
- Some consultants prefer no analgesics be administered so that their examination is not biased.
|
