Testicular torsion



Introduction
Epidemiology
Clinical features
Management


Introduction

Testicular torsion describes the twisting of the spermatic cord resulting in testicular ischaemia and necrosis. It most commonly seen in males aged between 10 and 30 (peak incidence 13-15 years).

Epidemiology

  • Incidence: 100.00 cases per 100,000 person-years
  • Peak incidence: 20-30 years
Condition Relative
incidence
Epididymo-orchitis2.00
Testicular torsion1
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Clinical features

Features
  • pain is usually severe and of sudden onset
  • the pain may be referred to the lower abdomen
  • nausea and vomiting may be present
  • on examination there is usually a swollen, tender testis retracted upwards. The skin may be reddened
  • cremasteric reflex is lost and elevation of the testis does not ease the pain

Management

Management
  • treatment is with surgical exploration. If a torted testis is identified then both testis should be fixed as the condition of bell clapper testis is often bilateral.