A Family Doctor's Tale - TESTICULAR TORSION

DOC I HAVE TESTICULAR TORSION

Testicular torsion is a rare condition which occurs in strenuous physical exercise which happened to one of my patients who suddenly found a sudden pain in the right testis. when I saw him he was in severe pain and his right testis was very tender and swollen. I referred him to hospital after giving him a pain killer.
He was operated on immediately after the ultrasound showed the presence of abnormal testis. Happily he was well after the operation.

Testicular torsion is the twisting of the testis on its cord either spontaneously or following strenuous activity.

It is a medical emergency as gangrene of testis may occur.

Testicular torsion is caused by
1.incomplete fixation of the epididymis to the testis

2.inadequate attachment of the mesorchium.(testicular body)

3.loose ligaments holding the testis to its cord .

Because of the loose attachment sudden movement of the testis on its cord may cause the testis to be twisted resulting sudden reduction of blood flow to the testis leading to gangrene of the testis.

Symptoms :
1.Severe pain in the testis

2.nausea and vomiting

3.fever

Signs:
1.scrotal swelling and edema

2.tenderness of the testis on palpation

3.redness and inflammation of the scrotal pouch

4.enlarged scrotal pouch

5.Ultrasound examination can detect the obvious torsion

Complications may be:
Damage to the testis with gangrene formation

The only treatment is surgical treatment to untangle the torsion and fasten the testis tightly to its attachment..

Removal of the testis (orchidectomy) may be necessary if there is gangrene.

The prognosis is usually excellent if treated early.

Gangrenous testis must be removed.