Testicular torsion

The testicular torsion is an acute stem rotation of the testis and epididymis with interruption of blood circulation and hemorrhagic infarction. The cause may be a lack of fusion of the testis, for example, then all it takes is one wrong move, for example, when crawling or while sitting on a bicycle saddle to achieve a twist. Often, this disease occurs in infancy or childhood. However, it can also occur in adolescent and adult males.

Symptoms

A testicular torsion usually leads to sudden severe pain. In 50 % of cases they occur at night. Occasionally, only makes a noticeable insidiously increasing pain, which is often confused with epididymitis. The pain may also radiate to the abdomen and groin. The scrotum is reddened to the relevant page and swollen testicles and is possibly high. Especially in infancy, the disease can also run painless and undetected. In a screaming baby who partout can not be calm, but the diagnosis should always be kept in mind.

Diagnostics

Prehn sign is negative ( lifting of the testis, remain pain, differential diagnosis of epididymitis ), Gersches characters ( collect at the bottom of the scrotum, occurs early on ) and Tenkhoffsches characters ( Pergamentknistern touching the scrotum occurs late ) give the first signs of testicular torsion. Urine and blood first enter no evidence after some time passes leukocytosis, as a sign of inflammation. This, however, is diagnostically irrelevant. Today often is directly sonography, evt also used with Doppler, with the edematous swelling and venous occlusion can be represented. As the investigation with the aid of ultrasonography does not provide absolute security and a torsion results in a short time to loss of the testicle and worse consequences in case of doubt the diagnostic surgical testicular exposure is necessary .. In a twist at the same time the treatment is performed.

Therapy

The torsion is always an emergency. Medical treatment is quickly needed, since the torsion can cause permanent damage after only four to six hours. Through an operation ( Detorquierung and orchidopexy ) you can save the testicle or remove it if necessary, if he is already infarcted. Normally, also the non-affected testicle is fixed to prevent a new twist to the latter. Due to the loss of the testis sperm production and hormone production may be restricted. The fertility and hormone production are sufficient with only one testicle but usually still present.

The torsion can sometimes be lifted manually without surgery.

Swell

• Disease in urology
• Disease in pediatric surgery
• Andrology
• Testicle