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Testicular torsion

Also known as Torsion Of Testis and Spermatic Cord Torsion

Testicular torsion occurs when the spermatic cord (from which the testicle is suspended) twists, cutting off the testicle's blood supply, a condition called ischemia. The principal symptom is rapid onset of testicular pain. The most common underlying cause is a congenital malformation known as a "bell-clapper deformity" wherein the testis is inadequately affixed to the scrotum allowing it to move freely on its axis and susceptible to induced twisting of the cord and its vessels. The diagnosis can be made clinically but an urgent ultrasound is helpful in evaluation. Irreversible ischemia begins around six hours after onset and emergency diagnosis and treatment is required within this time in order to minimize necrosis and to improve the chance of salvaging the testicle.

Source: Wikipedia

What are the symptoms?

Within all the people who go to their doctor with testicular torsion, 80% report having pain in testicles, 76% report having symptoms of the scrotum and testes, and 63% report having swelling of scrotum. The symptoms that are highly suggestive of testicular torsion are pain in testicles, symptoms of the scrotum and testes, swelling of scrotum, emotional symptoms, elbow cramps or spasms, nailbiting, itching of scrotum, elbow weakness, and muscle swelling, although you may still have testicular torsion without those symptoms.


What might my doctor prescribe?

Common Tests and Procedures

Patients with testicular torsion often receive intravenous fluid replacement, urinalysis, corneal transplant, procedures on spleen, removal of ectopic pregnancy, tracheostomy; temporary and permanent, diagnostic endocrine procedures and ct scan chest .

Common Medications

The most commonly prescribed drugs for patients with testicular torsion include morphine (rms), tretinoin topical, sulfamethoxazole (bactrim), codeine, methadone, cefazolin, chlorpheniramine / phenindamine / phenylpropanolamine, mecamylamine, grepafloxacin (raxar), malathion topical, gemtuzumab (mylotarg), gadoteridol (prohance) and carbinoxamine / dextromethorphan / phenylephrine .

Who is at risk?

Groups of people at highest risk for testicular torsion include sex == male, age 5-14 years and age 15-29 years. On the other hand, age 75+ years, age 60-74 years, and sex == female almost never get testicular torsion.

Age

< 1 years
0.1x
1-4 years
0.8x
5-14 years
4.9x
15-29 years
1.8x
30-44 years
0.3x
45-59 years
0.7x
60-74 years
0.0x
75+ years
0.0x

Sex

Male
2.3x
Female
0.0x

Race/Ethnicity

Black
0.7x
Hispanic
1.3x
White
1.0x
Other
0.9x
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