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Testicular Torsion

Adedamola Ayo Omole, M.D. and Jyothi R Patri, MD, MHA, FAAFP, HMDC Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Twisting of testis and spermatic cord, resulting in acute ischemia and loss of testis if unrecognized:

    • Intravaginal torsion: occurs within tunica vaginalis, only involves testis and s...

DIAGNOSIS

Testicular torsion is a clinical diagnosis. A good history and physicals are the most important and helpful tools in evaluating and managing TT. If H&P are highly suggestive of TT, imagi...

TREATMENT

  • Manual reduction/detorsion: best performed by experienced physician, especially if a surgeon is not available; may be successful, facilitated by lidocaine 1% (plain) injection at level of ex...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Postoperative visit at 1 to 2 weeks

  • Yearly visits until puberty may be needed to evaluate for atrophy.

  • Counsel high-risk patients during primary c...

REFERENCES

1
Boettcher  M, Bergholz  R, Krebs  TF, et al. Clinical predictors of testicular torsion in children. Urology.  2012;79(3):670–674. [View Abstract on OvidMedline...

ADDITIONAL READING

  • Feher AM, Bajory Z. A review of main controversial aspects of acute testicular torsion. Journal of Acute Diseases. 2016;5(1):1-8.

  • Jacobsen F...

CODES

ICD10

  • N44.03 Torsion of appendix testis

  • N44.0 Torsion of testis

  • N44.02 Intravaginal torsion of spermatic cord

  • N44.01 Extravaginal torsion of spermatic cord

  • N44.04 Torsion of appendix epididymis

  • N44.00...

CLINICAL PEARLS

  • The diagnosis of testicular torsion is usually made by physical exam. Patients with suspected torsion should be taken to the OR without delay. If the diagnosis is in question, a testic...

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