Testicular Torsion
Testicular Torsion is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Description
- Rotation of the testicle around the spermatic cord and vascular pedicle
- Rotation often occurs medially (two-thirds of cases):
- Ranges from incomplete (90–180°) to complete (360–1,080°) torsion
- Depending on the degree of torsion:
- Vascular occlusion occurs
- Infarction of the testicle after more than 6 hr of warm ischemia
- Testicular salvage:
- 73–100% with <6 hr of ischemia
- 50–70% at 6–12 hr
- <20% after 12 hr
- It is still worthwhile to attempt to salvage the testicle up to 24 hr after the onset.
- Testicular infarction leads to atrophy and may ultimately decrease fertility.
Epidemiology
Bimodal distribution of torsion:Epidemiology
- Peak incidences in infancy and adolescence
- 85% of cases occur between ages 12 and 18 yr, with a mean of 13 yr.
- Torsion is rare after age 30 but still possible.
Etiology
Etiology
- Congenital abnormality of the genitalia:
- High insertion of the tunica vaginalis on the spermatic cord
- Redundant mesorchium
- Permits increased mobility and twisting of the testicle on its vascular pedicle
- The anatomic abnormality is bilateral in 12%, so both testicles are susceptible to torsion.
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Citation
Rosen, Peter, et al., editors. "Testicular Torsion." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307321/all/Testicular_Torsion.
Testicular Torsion. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307321/all/Testicular_Torsion. Accessed December 5, 2019.
Testicular Torsion. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307321/all/Testicular_Torsion
Testicular Torsion [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 December 05]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307321/all/Testicular_Torsion.
* Article titles in AMA citation format should be in sentence-case
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