Color Doppler Sonography Reliably Identifies Testicular Torsion in Boys

Waldert, Matthias; Klatte, Tobias; Schmidbauer, Joerg; Remzi, Mesut; Lackner, Jakob; Marberger, Michael

doi:10.1016/j.urology.2009.07.1298

Cited by 99 publications

(93 citation statements)

References 21 publications

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“…10 A recent retrospective study of 298 patients who underwent CDS followed by surgery regardless of the result, CDS was shown to have a sensitivity and specificity for TT of 96.8% and 97.9%, respectively. 4 Positive and negative predictive values were 92.1% and 99.1%, respectively. Other studies have also shown similarly high sensitivity (95.7-100%) and specificity (85.3-100%) for CDS in diagnosing testicular torsion.…”

Section: Resultsmentioning

confidence: 95%

“…However, around 13-20% will have testicular torsion, with epididymo-orchitis the most common of the other contributing conditions. [1][2][3][4][5] Other conditions to consider in the differential diagnosis range from mumps orchitis, hematoma, renal colic, appendicitis and strangulated inguinal hernias and, rarities like the scrotal manifestations of Henoch-Schonlein purpura and communicating hematocoeles following abdominal trauma. 6,7 Testicular torsion can occur in several different ways, and can be classified as intravaginal, extravaginal or mesorchial.…”

Section: Resultsmentioning

confidence: 99%

“…Although the large majority of cases of TT are unprovoked, 4-10% of cases have been reported to occur in the setting of trauma. 4,9,20 In a normal scrotum, the testis is mobile, and the cord and epididymis is palpable posterior to the testis. In TT, the affected testis is usually riding high.…”

Section: Resultsmentioning

confidence: 99%

“…[16][17][18] Whilst the sign can be observer dependent and published reports have demonstrated an intact cremasteric reflex in cases of TT, its absence should raise significant clinical suspicion of the diagnosis. 4,22,23 The epididymis may be located medially, laterally or anteriorly, depending on the degree of torsion, but may appear normally located if there is 360 degree torsion, or may be difficult to palpate in a significantly edematous scrotum. A reactive hydrocele may be present, as well as scrotal edema.…”

Section: Resultsmentioning

confidence: 99%

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Surgical management of testicular torsion

et al. 2016

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Surgical management of testicular torsion

et al. 2016

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“…[1][2][3][4] The management of each patient depends on the individual clinical manifestations, laboratory and sonographic findings. Although it has been shown that colour Doppler sonography can identify testicular torsion in boys reliably, 5 the surgical exploration remains the gold standard diagnostic tool so as to maximise the chances of testicular salvage in case of testicular torsion. 6 After torsion of the testis and testicular appendix have been excluded, the acute scrotum in paediatric patients is frequently attributed to AE.…”

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confidence: 99%

The aetiology and current management of prepubertal epididymitis

Gkentzis

Lee

2014

annals

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INTRODUCTION The aim of this study was to review the published evidence on the pathogenesis and management of acute epididymitis (AE) in prepubertal boys after the authors encountered an unexpectedly large number of such cases in their institution. METHODS Using MEDLINE ® , a literature search was performed for articles in English with the words "pre-pubertal" OR "boys" OR "p(a)ediatric" OR "children" AND "epididymitis" OR "epididymo-orchitis". RESULTS The literature suggests that it is rare to find a bacterial infection or anatomical anomaly as a cause for AE in this population. A postviral infectious phenomenon is the most likely explanation. The management should be supportive and antibiotics reserved for those with pyuria or positive cultures. Urodynamic studies and renal tract ultrasonography have been advocated for those with recurrent epididymitis. CONCLUSIONS AE in prepubertal boys is more common than believed previously. A careful history for recent viral illnesses should be included. Antibiotics, urinary tract imaging and functional studies should be used in selected cases.

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A rare case of bilateral testicular torsion in a 57‐year‐old man

et al. 2021

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Context Testicular torsion, the twisting of the testis or spermatic cord, places the testis at risk of vascular compromise and is a surgical emergency. Testicular torsion is predominantly unilateral (98% of torsion cases) and primarily affects neonates and adolescents in a bimodal distribution. Bilateral testicular torsion is exceedingly rare (2% of cases) and is associated with neonates. To the authors’ best knowledge, there have been no reports of bilateral torsion in adult males over the age of 24. Case details A 57‐year‐old man presented to the emergency department 9 days after developing testicular pain while lifting his lawnmower. Ultrasonography performed at an outside facility was unremarkable. He was encouraged to followup with urology as an outpatient. Despite outpatient analgesia, he continued to experience pain and returned to the ED, where repeat ultrasonography demonstrated bilateral torsion with hypoperfusion. Discussion Although testicular torsion is uncommon, the clinician must recognize torsion; if left untreated, torsion leads to infertility. Previous publications suggest that ultrasonographic findings of bilateral testicular torsion should be attributed to “technical failure” rather than a plausible diagnosis. However, this case demonstrates the importance of maintaining a high index of suspicion, especially with an atypical age range and pathological presentation, particularly among men during their reproductive years.

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Color Doppler Sonography Reliably Identifies Testicular Torsion in Boys

Cited by 99 publications

References 21 publications

Surgical management of testicular torsion

Surgical management of testicular torsion

The aetiology and current management of prepubertal epididymitis

A rare case of bilateral testicular torsion in a 57‐year‐old man

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