Torsion of the testis and allied conditions

Abstract

In 15 years at Bristol there have been 293 cases of torsion of the testis, 55 cases of torsion of a testicular appendage and 5 cases of testicular ischaemia due to other causes. The risk of a male developing torsion of the testis or its appendix by the age of 25 is about 1 in 160. Both conditions occurred primarily in adolescents, but among prepubertal boys torsion of an appendage was as common as torsion of a normally descended testis. There was a slight left-sided preponderance in testicular torsion, more marked in torsion of the appendages; the incidence of bilateral torsion was 2-0 and 1-8 per cent respectively. The clinical features and differential diagnosis of the two conditions are compared. Torsion of a testicular appendage is the most commonly misdiagnosed scrotal lesion, the preoperative diagnosis being correct in only 11 per cent of cases compared with 90 per cent for torsion of the testis. Twenty-one cases of recurrent torsion underwent prophylactic bilateral orchidopexy. There were 20 cases of torsion of undescended testes, with a salvage rate of only 20 per cent. The overall testicular survival rate was 55-3 per cent. Viability depends upon the possibility of spontaneous reduction, the preoperative delay after the onset of symptoms, the degree of torsion of the cord and the length of follow-up in doubtful cases. Urgent scrotal exploration is advised in every case of acute testicular pain unless there is overwhelming evidence of epididymoorchitis. Exploration of the opposite side is mandatory in torsion of the testis and advisable in torsion of an appendage.

Metachronous bilateral torsion of the testicular appendices

“…2 In a recent report, a detailed preoperative history and physical examination diagnosed torsion of the appendix testis in only 26 of 95 patients. 6 Radionuclide imaging with technetium-99 m ( 99m Tc) sodium pertechnetate allows exclusion of testicular torsion.…”

“…Torsion of the appendix testis occurs during the prepubertal years (ages [7][8][9][10][11][12][13][14], often precipitated by trauma or exercise. 1,2 We report the successful sonographic imaging and non-operative management of a case of metachronous torsion of the appendix testis.…”

Torsión testicular en el paciente geriátrico. Y revisión de la literatura: a propósito de un caso

“…La torsión testicular es una etiología frecuente de escroto agudo en la infancia, con una incidencia aproximada de 1 por cada 4000 varones menores de 25 años 1 . En el adulto la frecuencia de esta nosología es menor, pero no inexistente, variando según las series entre el 8% y el 28% [1][2][3] .…”

“…En el adulto la frecuencia de esta nosología es menor, pero no inexistente, variando según las series entre el 8% y el 28% [1][2][3] . La incidencia disminuye con la edad.…”

Intermittent testicular torsion in 13-year boy

“…ИПЯ встреча-ется у половины больных, перенесших острый перекрут яичка. По данным литературы, 30-50 % пациентов, оперированных по поводу перекрута яичка, в анамне-зе имели неоднократные эпизоды острых болей в яичке [1,2]. Диагностика ИПЯ затруднена в связи с непосто-янными и кратковременными клиническими прояв-лениями.…”