Symptoms of testicular torsion are a result of a faulty connection between the scrotum and the testicle. This is a condition that is caused by an inherited trait. This causes the scrotum to twist around the testicle, resulting in pain, rashes, and even the possibility of having to remove the scrotum. However, there are also treatments for this condition.
Symptoms
Symptoms of testicular torsion include sudden pain in the testicles. It’s an emergency condition, so it’s important to seek treatment as soon as possible. If left untreated, torsion can lead to permanent damage.
The best results occur when the torsion is treated within eight hours. This is because the testicle’s blood flow is crucial. If it’s cut off for more than six hours, it’s possible for the testicle to shrink. A person with torsion may also have to urinate frequently.
The condition can occur in people of any age, but it’s most common in adolescents. It can be caused by a variety of factors, including injury to the testicle. It can also run in families.
Testicular torsion can cause a testicle to become stuck in the scrotum. If it’s left untreated, it can damage the testicle permanently. It can also affect the production of hormones in an infant.
Many people with torsion have a family history of the condition. Knowing this can help a patient seek emergency treatment.
To diagnose testicular torsion, a doctor will examine the testicles. He or she will also check the scrotum and abdomen. He or she may use ultrasound to assess the scrotal blood flow. If the flow is blocked, doctors may recommend a procedure to correct the torsion.
Surgery is often used to treat torsion. This is known as orchiopexy. Surgical procedures are typically performed through the scrotum, but they can sometimes be done through the groin.
Before surgery, doctors will check the scrotum and abdomen to make sure there isn’t another underlying cause. They may also perform a Doppler to evaluate the flow of venous and arterial blood. A nuclear scan can also confirm the diagnosis.
Diagnosis
Identifying testicular torsion early is crucial for a complete recovery and prevents the need for further surgery. The diagnosis of torsion is usually made during the physical exam and is confirmed by ultrasound or x-ray.
A testicular torsion is typically caused by the twisting of the spermatic cord. However, it can occur without symptoms. There are a variety of ways to identify testicular torsion, and many clinicians need to be familiar with its presentation.
Testicular torsion can cause pain and swelling in the scrotum. If the condition is not diagnosed early, it can lead to severe damage to the testicle.
Depending on the severity of the torsion, it may be necessary to remove the affected testicle. This procedure is done through the scrotum and can be performed by a surgeon.
While it is rare for a single viable testicle to be affected, if the torsion is left untreated, it can result in long-term sequelae. Infertility can be a problem in patients who are born with torsion, so a quick diagnosis and surgical repair are essential to ensure a full recovery.
Testicular torsion is a medical emergency and must be treated immediately. The patient should be admitted quickly and all blood work completed. The triage nurse should also contact the ED physician and plan an immediate consultation.
Detection strategies include point-of-care ultrasound (POCUS), scrotal ultrasonography, and scrotal MRI. POCUS improves the accuracy of diagnosis and can help facilitate surgical consultation and definitive treatment. It is not required for Institutional Review Board (IRB) approval, so it can be used in resource-limited settings.
A history of torsion should prompt an immediate urology consultation. It is important to determine the etiology of testicular torsion, as sorting out the etiology is often a complicated process.
Treatment
Surgical treatment for testicular torsion should be performed as soon as the patient exhibits signs of torsion. This will help to prevent the testicle from becoming necrotic. In the meantime, pain control is crucial to ensure a comfortable experience for the patient.
In addition to physical rest, the use of analgesics and anti-anxiety medications are effective adjuncts in the treatment of testicular torsion. In addition, a urinary tract infection test should be performed to rule out an infection.
For an accurate diagnosis of the condition, ultrasound is a helpful tool. During an ultrasound, the doctor can see if the blood flow to the testicle is blocked or obstructed. The Doppler is also helpful in evaluating venous and arterial flow.
The golden hour for testicular torsion treatment is within 6 hours of the onset of symptoms. This is important because the earlier the treatment, the more likely the patient will be able to save the testicle.
The condition is most common in younger men. However, it can also affect older men and newborns. It may be caused by a sports injury or rapid growth during puberty. It can also be caused by a bell clapper deformity, which causes the testicles to twist.
The symptoms of testicular torsion include sudden scrotal pain. The pain may start in the abdomen and then spread to the groin, flank, and lower abdominal area. It is sometimes associated with nausea and vomiting.
If the symptoms do not respond to treatment, the affected testicle may need to be removed. This is usually done through a small incision made through the scrotum. The doctor may recommend rest and NSAIDs for a few days.
Bilateral torsion
Surgical intervention is the definitive treatment for testicular torsion. The testicle is at risk for serious damage, including atrophy and gangrene, if left untreated. In addition to severe pain, testicular torsion can lead to nausea, vomiting, and scrotal swelling.
The incidence of bilateral torsion is exceedingly rare. In the past, some authors have advocated conservative management, but recent research has demonstrated that immediate emergency surgery is essential in many cases.
This case illustrates the importance of maintaining a high index of suspicion. The patient presented to the emergency department with a history of right groin pain nine days prior. His pain was recurrent and localized to the bilateral testes. Despite outpatient analgesia, the patient’s pain progressively worsened.
The initial laboratory findings included a complete blood count, a basic metabolic panel, and a scrotal ultrasound. The ultrasound showed homogeneous echotexture with the decreased arterial flow in the bilateral testes. The Doppler study was positive and confirmed the diagnosis of bilateral torsion.
Urine tests were negative for infection. The patient underwent emergent surgical exploration and underwent left orchiectomy. Afterward, he was discharged and instructed to follow up with a urological service as an outpatient.
There are two primary ways of treating bilateral torsion: manual detorsion and emergency surgery. Manual detorsion involves the use of two or three 360-degree rotations of the testicle.
During the procedure, the testis is gently grasped by the physician and rotated away from the midline. After the testis is completely untwisted, blood flow can be restored. Depending on the severity of the torsion, the testicle may be able to be saved. The best outcomes are reported when the testicle is torsed within four to six hours.
Inherited trait
Symptoms of testicular torsion include sudden pain, swelling, and restricted blood flow. Doctors can treat the condition by performing surgery. The testicle may also be removed or replaced with a prosthetic. The patient will need to avoid sexual activities for a few weeks. Afterward, he or she will be able to father children.
The gene DHX37 is believed to play a critical role in the development of the testis. Dose-dependent abnormalities of the gene are observed in testicular torsion. Currently, it is unclear whether there is a causal relationship between the genes involved.
Genetically predisposed individuals have higher chances of developing testicular torsion. Some researchers suggest that an inherited trait may cause the condition. Other risk factors are rapid growth during puberty and injury to the testicles.
Inheritance of testicular torsion is a rare disease. It affects only about 2% of men in the United States. Typically, the disorder is found in 12- to 18-year-old boys, though it can occur in older males as well. Fortunately, the condition is preventable with surgery.
Some people develop testicular torsion after a minor scrotum injury. Other causes can include cold weather, physical activity, or sexual arousal. However, in most cases, there is no known cause of the condition.
Testicular torsion is caused by a defect in the development of a protective sac around the testes in the scrotum. The cord that supplies blood and nerves to the testes, known as the spermatic cord, is often twisted. This can damage the testicle and cause infection. It is important to see a doctor right away if you suspect that you have the condition. If left untreated, the testicle can become damaged permanently.
Health Sources:
Health A to Z. (n.d.). HSE.ie. https://www2.hse.ie/az/
U.S. National Library of Medicine. (n.d.). https://www.ncbi.nlm.nih.gov/
Directory Health Topics. (n.d.). https://www.healthline.com/directory/topics
Health A-Z. (2022, April 26). Verywell Health. https://www.verywellhealth.com/health-a-z-4014770
Harvard Health. (2015, November 17). Health A to Z. https://www.health.harvard.edu/health-a-to-z
Health Conditions A-Z Sitemap. (n.d.). EverydayHealth.com. https://www.everydayhealth.com/conditions/
