Testicular torsion

Classification according to ICD-10
N44.0	Testicular torsion
ICD-10 online (WHO version 2019)

Testicles removed from a dog after rotation. For comparison, the healthy testicle on the left

The torsion is an acute stem rotation of testis and epididymis with interruption of the blood circulation and hemorrhagic infarction . The cause can be B. be an insufficient adhesion of the testicular sheaths, then a wrong movement is enough z. B. when crawling or when sitting on a bicycle saddle to achieve a twist. This disease often occurs in infancy or childhood. However, it can also occur in adolescent and adult men.

Symptoms

Testicular torsion usually leads to sudden severe pain. In 50% of cases, they occur at night. Occasionally, only a gradual increase in pain becomes noticeable, which is often mistaken for epididymitis . The pain can also radiate to the abdomen and groin. The scrotum is reddened on the corresponding side and the testicle swollen and possibly high. Especially in infancy, the disease can also be painless and undetected. In the case of a crying baby who cannot be calm down at all, the diagnosis should always be kept in mind.

Diagnosis

Prehn's sign negative (lifting of the testicle, pain persists , differential diagnosis to epididymitis), Ger's sign (retraction at the bottom of the scrotum, occurs early) and Tenkhoff's sign (parchment crackling when touching the scrotum, occurs late) are the first signs of testicular torsion . Urine and blood give no clues at first, after a while leukocytosis occurs as a sign of inflammation. However, this is of no diagnostic significance. Today sonography is often used directly, possibly also with Doppler , with which the edematous swelling and venous occlusion can be shown. Since the examination with the help of sonography does not offer absolute certainty and a torsion leads to loss of the testicle and worse consequences in a short time, diagnostic surgical testicle exposure is necessary in case of doubt. In the case of torsion, therapy is carried out at the same time.

therapy

Testicular torsion is always an emergency. Medical help is required quickly as the torsion can cause permanent damage after four to six hours. An operation (detorquation) can save the testicle or, if necessary, remove it if it is already infarcted . Normally, the unaffected testicle is also fixed to prevent it from being twisted again ( orchidopexy ). Loss of the testicle can limit sperm and hormone production. However, fertility and sufficient hormone production are usually still given with only one testicle.

The torsion can sometimes be reversed manually without surgery.

swell

1. ↑ D. Manski: Online textbook of urology . http://www.urologielehrbuch.de/hodentorsion.html
2. ↑ Timothy J Rupp: Testicular Torsion in Emergency Medicine. emedicine.medscape.com, updated August 12, 2015, accessed September 15, 2015
3. ↑ HU Braedel, TC Bright, S. Chlepas: Traumatology of the urogenital tract . Springer-Verlag, March 12, 2013, ISBN 978-3-642-80573-8 , p. 286.

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !