TESTICULAR TORSION

Testicular Torsion

Causes

Testicular torsion occurs when the spermatic cord, which supplies blood to the testis, becomes twisted. This can lead to a loss of blood flow and damage to the testicle. Common causes include:

1. Congenital Factors: "Bell clapper deformity," where the testis is not properly attached within the scrotum, allowing it to rotate.

2. Trauma: Injury to the testicles or scrotum.

3. Physical Activity: Sudden movements or strenuous activities may trigger torsion.

4. Sleep: Can occur during sleep due to relaxation of the muscles and spontaneous movement.

5. Age: Most common in males aged 12–18 years.

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Signs and Symptoms

1. Sudden, Severe Pain: Intense pain in the affected testicle, often without warning.

2. Swelling: Enlargement of the scrotum, sometimes accompanied by redness.

3. Nausea and Vomiting: Common due to severe pain.

4. Abdominal Pain: May occur, especially in younger boys.

5. High Testicle Position: The affected testicle may be higher than usual and oriented abnormally.

6. Loss of Cremasteric Reflex: Stroking the inner thigh fails to cause the testicle to retract.

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Effects

If left untreated, testicular torsion can lead to:

1. Ischemia: Lack of blood flow can result in tissue death.

2. Testicular Atrophy: Shrinkage of the testis over time.

3. Infertility: Damage to the testis may impair sperm production.

4. Loss of Testicle: Prolonged torsion can necessitate surgical removal of the affected testis.

5. Psychological Impact: Emotional distress from loss or dysfunction of the testicle.

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Solutions

1. Emergency Surgery (Detorsion): Surgery to untwist the spermatic cord and restore blood flow.

Time is critical: The testicle can usually be saved if treated within 6 hours.

2. Orchiopexy: Surgical fixation of both testes to prevent recurrence.

3. Pain Management: Medications for symptom relief before and after surgery.

4. Removal of Dead Testis: If the testicle is no longer viable, it may need to be removed (orchiectomy).

5. Post-Surgery Care: Follow-up to ensure healing and check for complications.

If you suspect testicular torsion, seek immediate medical attention, as delayed treatment increases the risk of irreversible damage.