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Testicular Torsion

Adedamola Ayo Omole, M.D. and William Pearce, MD Reviewed 04/2024
 


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 an experienced physician, especially if a surgeon is not available; may be successful, facilitated by lidocaine 1% (plain) injection at level of...

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
Sharp VJ, Kieran K, Arlen AM. Testicular torsion: diagnosis, evaluation, and management. Am Fam Physician. 2013;88(12):835-40.
2
Bowlin PR, Gatti JM, Murphy JP. Pediatric Testicular Torsion....

ADDITIONAL READING

Jacobsen FM, Rudlang TM, Fode M, et al. The Impact of Testicular Torsion on Testicular Function. World J Mens Health. 2020;38(3):298-307.  

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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