Materiały źródłowe

• #1 Testicular torsion – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/testicular-torsion/symptoms-causes/syc-20378270

  Testicular torsion occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum. The reduced blood flow causes sudden and often severe pain and swelling. […] Signs and symptoms of testicular torsion include: Sudden, severe pain in the scrotum the loose bag of skin under your penis that contains the testicles, Swelling of the scrotum, Abdominal pain, Nausea and vomiting, A testicle that’s positioned higher than normal or at an unusual angle, Frequent urination, Fever. […] Young boys who have testicular torsion typically wake up due to scrotal pain in the middle of the night or early in the morning. […] Seek emergency care for sudden or severe testicle pain. Prompt treatment can prevent severe damage or loss of your testicle if you have testicular torsion. […] You also need to seek prompt medical help if you’ve had sudden testicle pain that goes away without treatment. This can occur when a testicle twists and then untwists on its own (intermittent torsion and detorsion). Surgery is frequently needed to prevent the problem from happening again.

• #2 Testicular Torsion: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15382-testicular-torsion

  Testicular torsion is a painful condition where your testicle twists and loses its blood supply. It requires emergency care. If the blood supply doesnt return quickly (within six hours), a healthcare provider may need to surgically remove your testicle. […] Testicular torsion is a serious and painful condition that affects your testicle(s). If you experience testicular torsion, the spermatic cord twists and cuts off blood flow to your testicle. If you dont get immediate treatment, your testicle could die. […] Testicular torsion is a very serious medical emergency. If you have sudden, intense pain in one of your testicles, call a healthcare provider or go to an emergency room (ER) right away. […] The main symptom of testicular torsion is sudden, severe pain in one of your testicles. It can occur at any time when youre awake, sleeping, standing, sitting or active.

• #3 Testicular Torsion – Signs – Emergency Management – TeachMeSurgery

  https://teachmesurgery.com/urology/genital-tract/testicular-torsion/

  Testicular torsion occurs when the spermatic cord and its contents twists within the tunica vaginalis, compromising the blood supply to the testicle. Testicular torsion is a surgical emergency, as without treatment the affected testicle will infarct and die within hours. Patients will generally present with sudden onset severe unilateral testicular pain. This is often associated with nausea and vomiting, secondary to the pain. Referred abdominal pain can also occur. On examination, the testis will have a high position (compared to the contralateral side) with a horizontal lie. It can also appear swollen and will be extremely tender. Classically, the cremasteric reflex is absent and pain continues despite elevation of the testicle, termed a negative Prehns sign. Testicular torsion is a surgical emergency with a 4-6hrs window from the onset of symptoms to salvage the testis before significant ischaemic damage occurs. Delay in surgical exploration leading to prolonged ischaemia can result in testicular infarction; the chance of this happening increases exponentially with time since onset of pain. Testicular salvage rates are 90-100% if surgery performed within 6hrs of onset of pain, and this decreases to 50% if symptoms are present for more than 12 hours.

• #4 Testicular Torsion | Causes, Symptoms & Treatment

  https://www.cincinnatichildrens.org/health/t/testicular-torsion

  Testicular torsion is the twisting of the tube, called the spermatic cord, which leads to the testicle. When this happens, little or no blood is able to flow to that area. This condition is a surgical emergency. The testicle can survive for only about six to eight hours without any blood flowing to it. After that, the tissues are damaged, and the testicle no longer works. […] Testicular torsion can happen at any age. However, it is most common in newborns or boys going through puberty. When testicular torsion happens during the newborn period, there is a very high chance that the testicle has already been severely damaged and may not be saved. […] Symptoms can vary based on the age of the child. In newborns, there is usually no pain, but the affected side of the scrotum becomes swollen, causing it to become red and hard. Parents may notice scrotal swelling during a diaper change, or the doctor will find it during a newborn exam. In older children and adults, the most common symptom is a painful and swollen scrotum. Often, they will vomit and have pain in the lower portion of the belly. The testicle may also lie in an abnormal position (for example, lying sideways in the scrotum). […] Testicular torsion is a surgical emergency. If the twist has been present for more than eight hours, there is only a 60% chance of saving the testicle.

• #5 Testicular Torsion: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/2036003-overview

  Testicular torsion is defined as a twisting of the spermatic cord structures, followed by venous congestion, loss of arterial inflow, and subsequent ischemia of the ipsilateral testis. This is considered a urologic emergency; it necessitates expeditious diagnosis and treatment to preserve testicular vitality. The testicular salvage rate decreases significantly if treatment is delayed by more than six hours from symptom onset. […] The acute scrotum includes a variety of disease processes and can present in any age group. Testicular torsion has a bimodal age distribution, primarily affecting neonates and adolescents. However, it has been noted in adult males and should therefore be included in the differential workup of testicular pain, regardless of patient age. […] Prompt surgical treatment is crucial to preventing ischemic injury to the testis and possible testicular loss. Manual detorsion may be attempted during the initial examination, but even if manual detorsion is successful, surgical exploration and testicular fixation should be performed prior to the patient being discharged from the hospital.

• #6 Testicular Torsion – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448199/

  Testicular torsion is a time-dependent diagnosis, a true urologic emergency, and early evaluation can assist in urologic intervention to prevent testicular loss. […] Testicular viability significantly decreases 6 hours after the onset of symptoms; hence, early diagnosis is key. […] Testicular torsion often presents as an abrupt onset of unilateral scrotal pain. The pain may be constant or intermittent but not positional. The patient may have associated symptoms of nausea or vomiting. […] The testicle may be swollen, erythematous, and have an absence of the normal cremasteric reflex; however, it should be noted that the presence or absence of the cremasteric reflex is not as sensitive as once thought. […] The outcomes of testicular torsion depend on when the patient presents to the ED and how quickly the diagnosis is made and treatment is undertaken. Delays in diagnosis and treatment always lead to testicular atrophy. About 20% to 40% of cases of testicular torsion result in an orchiectomy. The risk of losing a testis is much higher among African Americans and younger males. For those who present within the first 6 hours of symptoms, the salvage rate is nearly 100%, but this number quickly drops to less than 50% if the delay in seeking help is more than 12 to 24 hours.

• #7

  https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-genitourinary/testicular-torsion

  23 year old male with no past medical history presents with sudden onset of left groin and scrotal pain. Patient reports that his symptoms started approx 45 mins prior while playing basketball. The pain has been constant without relieving factors. […] Patients often describe fairly sudden, severe unilateral testicular pain, sometimes radiating into the abdomen. They may have associated nausea and vomiting. The left testicle is more frequently affected. […] The affected testicle is usually exquisitely tender and swollen. It may sit higher within the scrotum than the unaffected testicle, and may have a transverse lie. […] Several studies have found loss of the cremasteric reflex to be the most accurate sign of testicular torsion. […] Testicular torsion is primarily a clinical diagnosis. If a patient has the classic symptoms of sudden onset of pain, diffuse swelling and testicular tenderness, and loss of cremasteric reflex, a presumptive diagnosis can be made and no further testing is necessary. […] Testicular nonviability can occur in a little as 6 hours after onset or torsion.

• #8

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Testicular-Torsion.aspx

  Testicular pain in teens could be a sign of testicular torsion. […] The most important thing to know about testicular torsion is that it is an emergency that must be treated immediately. […] The time from the start of symptoms until treatment is the most important factor in being able to save the testicle. […] The pain is excruciating, but somehow many boys or their parents try to ignore it. […] If the torsion isn’t corrected quickly, the testicle may die. […] The symptoms of testicular torsion may involve one or both of the testes. […] The following are the most common symptoms of testicular torsion. […] Symptoms may include: Pain in the scrotum (Usually on one side, sudden, and severe) […] Not all severe scrotal pain is torsion, but since the cause of pain isn’t known until a boy is evaluated, all cases of severe scrotal pain need to be treated as an emergency.

• #9 Testicular torsion | healthdirect

  https://www.healthdirect.gov.au/testicular-torsion

  Testicular torsion is when your testicle twists around, cutting off its blood supply. […] It causes sudden, severe pain and swelling in your scrotum. […] Symptoms of testicular torsion include: sudden, severe pain in your scrotum, swelling and redness of your scrotum, nausea and/or vomiting, pain in your lower abdomen or thigh, your testicle being higher than normal or on an unusual angle, difficulty walking. […] Testicular torsion is an emergency. If the blood supply is cut off for too long, your testicle could become permanently damaged. […] If you or your child has sudden pain in the scrotum or sudden pain in the lower abdomen (tummy area), go to your nearest hospital emergency department immediately. These are signs of testicular torsion, which is an emergency and requires surgery within a few hours.

• #10 Testicular Torsion: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15382-testicular-torsion

  Other testicular torsion symptoms include: Painful swelling on one side of your scrotum. A visible lump on a testicle. One testicle is higher in your scrotum than the other. Discoloration (red, purple, brown, black) in your scrotum. Nausea and vomiting. Abdominal pain. Peeing more than usual. Fever. […] If you have sudden pain or discomfort in one or both testicles, but no other symptoms, you should still contact a healthcare provider right away. This is still a sign of a medical emergency. […] In most people, testicular torsion feels like a sudden, intense pain in your testicle that sometimes extends to your stomach or makes you feel like youre going to throw up. It may be so painful that you have trouble walking. […] Without prompt treatment, testicular torsion may cause: Permanent damage to your testicle. Your testicles can only survive about six hours without blood flow. If your testicle dies, a surgeon must remove it from your scrotum.

• #11 Testicular Torsion (for Teens) | Nemours KidsHealth

  https://kidshealth.org/en/teens/torsion.html

  Testicular torsion is an emergency condition. It happens when the spermatic cord, which provides blood flow to the testicle, rotates and becomes twisted. The twisting cuts off the testicle’s blood supply and causes sudden pain and swelling. […] Testicular torsion requires surgery right away to save the testicle. Testicular torsion that goes on for more than a few hours can permanently damage the testicle, and a damaged testicle must be removed. […] When the cord twists, it cuts off blood supply to the testicle. A guy will feel pain and notice swelling in the testicle. This is a sign to get medical help. […] The longer the cord stays twisted, the harder it is for doctors to save the testicle. Ignoring pain or hoping it goes away can end in severe damage to the testicle. […] If you have a testicular torsion, chances are you’ll know it. You’ll feel a sudden, possibly severe pain in your scrotum and one of your testicles. The pain might increase and decrease but generally won’t go away completely. Other symptoms include swelling, especially on one side of the scrotum, nausea and vomiting, belly pain, and one testicle appears to be higher than the other.

• #12 Testicular torsion | Children’s Health Queensland

  https://www.childrens.health.qld.gov.au/health-a-to-z/testicular-torsion

  Testicular torsion occurs when there is a twist of the spermatic cord (the cord that runs between the testicles and openings at the level of the bladder, containing blood vessels, sperm tube and nerves). This twist blocks blood flow to the testicles, which can cause irreparable damage to the testicle if not treated within a few hours. […] Testicular torsion is a surgical emergency. The health of the testis can decline significantly from six hours after the onset of symptoms. […] The following symptoms can indicate testicular torsion: pain in the testicles and/or the lower abdomen on the same side, nausea, vomiting, dizziness. […] The following signs can indicate your child has testicular torsion: tenderness or swelling of the testis, a testicle that sits higher within the scrotum, or one that lies crossways rather than vertically, redness and swelling of the scrotal skin, discomfort when walking or sitting. […] If your child is experiencing pain in the testicles or lower abdomen, take them immediately to your closest emergency department.

• #13 Testicular torsion: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000517.htm

  Testicular torsion is twisting of the spermatic cord, which supports the testes in the scrotum. When this occurs, blood supply is cut off to the testicles and nearby tissue in the scrotum. This may cause permanent damage to the testicle. […] Symptoms include: Sudden severe pain in one testicle. The pain may occur without a clear reason. Swelling within one side of the scrotum (scrotal swelling). Nausea or vomiting. […] Additional symptoms that may be associated with this disease: Testicle lump, Blood in the semen, Testicle pulled to a higher position in scrotum than normal (high riding). […] The testicle may continue to function properly if the condition is found early and treated right away. The chances that the testicle will need to be removed increase if blood flow is reduced for more than 6 hours. However, sometimes it may lose its ability to function even if torsion has lasted fewer than 6 hours.

• #14 Testicular Torsion | Men’s Health

  https://health.ucdavis.edu/conditions/testicular-torsion

  Testicular torsion is a medical emergency. It happens when a testicle twists inside your scrotum, cutting off its blood supply. […] If you experience sudden or intense testicular pain on one side, seek emergency care immediately. Treatment within six hours of your symptoms starting can prevent lasting damage to your testicle. […] Other emergency signs of testicular torsion include: Blood in your semen (whitish fluid your penis ejaculates), Change in your scrotums skin color, including redness or bruising, Lump on one testicle, Nausea and vomiting, Swelling in one testicle, Testicle that is sitting higher than the other one (riding high). […] Without blood, your testicle will shrink and can eventually die. Thats why its so important to seek medical care to restore blood flow. Physicians can save most testicles when they treat testicular torsion within the first six hours.

• #15 Testicular Torsion „Double Outch!” – Fairbanks Urology

  https://fairbanksurology.com/condition/testicular-torsion-double-outch/

  Testicular torsion occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum. The reduced blood flow causes sudden and often severe pain and swelling. […] Signs of testicular torsion include: Sudden, severe pain in the scrotum, Swelling of the scrotum, Abdominal pain, Nausea and vomiting, A testicle that’s positioned higher than normal or at an unusual angle, Painful urination, Fever. […] Seek emergency care for sudden or severe testicle pain. Prompt treatment can prevent severe damage or loss of your testicle if you have testicular torsion. […] Testicular torsion can cause the following complications: Damage to or death of the testicle. When testicular torsion is not treated for several hours, blocked blood flow can cause permanent damage to the testicle. If the testicle is badly damaged, it has to be surgically removed.

• #16 Testicular torsion – information for teenagers | CUH

  https://www.cuh.nhs.uk/patient-information/testicular-torsion-information-for-teenagers/

  Testicular torsion occurs when the cord (called the spermatic cord) which carries blood to the testicle becomes twisted. The twisting cuts off the blood supply to the testicle which causes pain and swelling. Testicular torsion is therefore a condition which necessitates emergency management. […] What are the symptoms of testicular torsion? Pain in the testis/ scrotum pain is often severe, often comes on suddenly and may be associated with feeling or being sick. Pain may come and go but tends not to go away. Swelling, especially on one side of the scrotum. Redness. Abdominal (tummy) pain. Your testicle may have been sitting higher than usual in the scrotum and may be in a more horizontal position than usual. […] Testicular torsion may occur during exercise or during sleep and may occur after a trauma or injury to the testicle.

• #17 Testicular Torsion – Kidshealth | Akron Children’s

  https://www.akronchildrens.org/kidshealth/en/parents/torsion.html

  Testicular torsion is a medical emergency. It happens when the spermatic cord, which provides blood flow to the testicle, rotates and becomes twisted. This cuts off the testicle’s blood supply and causes sudden pain and swelling. Testicular torsion usually needs immediate surgery to save the testicle. […] When the cord twists, it cuts off blood supply to the testicle. A guy will feel pain and notice swelling in the testicle. This is a sign to get medical help. […] The longer the cord stays twisted, the harder it is for doctors to save the testicle. Ignoring pain or hoping it goes away can end in severe damage to the testicle. […] Testicular torsion can happen to guys of any age, but it’s most common in teens. Most of the time there’s no obvious cause. Testicular torsion can happen after an injury, during exercise, or even during sleep.

• #17 Testicular Torsion – Kidshealth | Akron Children’s

  https://www.akronchildrens.org/kidshealth/en/parents/torsion.html

  If your son has testicular torsion, he’ll feel a sudden, possibly severe pain in his scrotum and one of his testicles. The pain can get worse or ease a bit, but probably won’t go away completely. […] Other symptoms: swelling, especially on one side of the scrotum; nausea and vomiting; belly pain; one testicle appears to be higher than the other. […] Saving a testicle becomes more difficult the longer the spermatic cord stays twisted. The degree of twisting (whether it’s one entire revolution or several) determines how quickly the testicle will become damaged. As a general rule: within about 46 hours of the start of the torsion, the testicle can be saved 90% of the time; after 12 hours, this drops to 50%; after 24 hours, the testicle can be saved only 10% of the time. […] Boys need to know that genital pain is serious. Ignoring pain or simply hoping it goes away can lead to severe damage to the testicle and even its removal. Even if pain in the scrotum that goes away, your son still needs to tell you or a doctor and get checked out. A torsion that goes away makes him more likely to have another one. Doctors can greatly reduce the risk of another torsion by securing the testicles to the scrotum.

• #18 Testicular torsion | healthdirect

  https://www.healthdirect.gov.au/testicular-torsion

  Sometimes, testicular torsion can cause a sudden pain that goes away without treatment. This happens if your testicle twists and then untwists on its own. If this happens, see a doctor as soon as possible. You may need surgery to prevent it happening again. […] Testicular torsion is generally treated with surgery, which is done as soon as possible. For the best chance of preventing permanent damage your testicle, surgery should be done within 6 hours from when the pain started.

• #19 Testicular torsion: Causes, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/190514

  Even if the testicle untwists on its own, it is important to seek prompt medical help because surgery is necessary to prevent the problem from recurring. […] Surgery within 68 hours of testicular torsion has a good likelihood of saving the testicle, although recent research states waiting longer can still result in a doctor being able to save the testicle. […] The longer a person delays treatment, the lower the likelihood of saving the affected testicle. […] Prolonging treatment can cause permanent damage and affect a persons fertility. […] For this reason, the sooner a doctor can untwist the testicle, the greater the chances of successful treatment.

• #20 Testicular torsion | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/testicular-torsion?lang=us

  Testicular torsion occurs when a testis torts on the spermatic cord resulting in the cutting off of blood supply. The most common symptom is acute testicular pain and the most common underlying cause, a bell-clapper deformity. […] The onset of severe testicular pain is sudden and is not relieved by elevation of the scrotum. There should be no fever or urethral discharge. […] It is important to recognize that some patients may present with intermittent symptoms due to spontaneous detorsion, so-called intermittent testicular torsion. This subentity has been increasingly reported in the literature. Short periods of acute groin pain accompanied by vomiting and subsequent spontaneous relief may be typical patient history in these cases. […] Initially, torsion is sufficient only to obstruct venous outflow (incomplete torsion, less than 360 degrees), resulting in the gradual increase in intratesticular pressure and resistance. Over time and with an additional twisting of the cord (greater than 360 degrees), the arterial inflow is also obstructed, and the testis becomes entirely ischemic.

• #20 Testicular torsion | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/testicular-torsion?lang=us

  The key to successful treatment is rapid diagnosis and surgical intervention. If diagnosed early enough, the testis can be detorted with little damage. If the testis has necrosed, then orchiectomy is required. […] Likelihood of salvage of the testis is directly related to the time between onset and detorsion (whether it be surgical or spontaneous): 6 hours: ~100% salvage; 6-12 hours: 50%; 12-24 hours: 20%. […] As intermittent testicular torsion ultimately may progress to acute infarction, elective testicular fixation may be indicated and has demonstrated excellent results in smaller series.

• #21 Testicular torsion – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/testicular-torsion/diagnosis-treatment/drc-20378274

  Your doctor will ask you questions to verify whether your signs and symptoms are caused by testicular torsion or something else. Doctors often diagnose testicular torsion with a physical exam of the scrotum, testicles, abdomen and groin. […] The sooner the testicle is untwisted, the greater the chance it can be saved. After six hours from the start of pain, the chances of needing testicle removal are greatly increased. If treatment is delayed more than 12 hours from the start of pain, there is at least a 75 percent chance of needing testicle removal. […] Testicular torsion can occur in newborns and infants, though it’s rare. The infant’s testicle might be hard, swollen or a darker color. Ultrasound might not detect reduced blood flow to the infant’s scrotum, so surgery might be needed to confirm testicular torsion.

• #22 Testicular Torsion | UCSF Department of Urology

  https://urology.ucsf.edu/patient-care/children/testicular-torsion

  Newborns typically do not have pain. Torsion is identified in newborns because the scrotum is discolored (appears bruised) or firm. […] Adolescents usually have severe pain in the testicle that may cause nausea and vomiting. The adolescent will have a swollen scrotum and the testis may be higher up in the scrotum compared with the other testicle. […] The likelihood for survival is better the faster the torsion is fixed. Ideally, the testicle should be untwisted with surgery within 4 hours of the onset of symptoms. The longer the amount of time waited the more likely the testicle will not survive.

• #23 Testicular Torsion – Children’s Hospital of Orange County

  https://choc.org/programs-services/urology/testicular-torsion/

  Testicular torsion is a medical emergency. If you suspect your child has testicular torsion, he should be taken to the closest emergency room. […] The symptoms of testicular torsion may involve one or both of the testes. Although each child may experience symptoms differently, the following are the most common symptoms of testicular torsion. Scrotal (involving the scrotum) pain or tenderness, swelling, bruising, firmness, redness and/or high-lying testicles. Nausea and vomiting. Loss of cremasteric reflex, which is the reflex involved in controlling testicular movement into the pelvic cavity that is normally brought on by cold, touch, or exercise. […] The chance of survival for the testicle is best if surgery is completed within six hours of symptom onset. […] In newborns who had testicular torsion in utero, the symptoms can vary from an undescended testes (testes that have not passed down into the scrotal sac), atrophic testes (testes that have shrunk) or non-palpable testes (testes that cannot be felt). These are usually noticed after birth and may appear as a hard and/or discolored region in the scrotum or groin region.

• #24 Testicular Torsion: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/2036003-overview

  The significant consequence of torsion of the spermatic cord is testicular ischemia. The magnitude of ischemia is determined by both the degree of rotation and the duration of the torsion. […] Depending on the severity of ischemia, the morphologic changes range from vascular congestion to hemorrhagic necrosis of the testis. Animal studies have demonstrated a loss of all spermatogenic and Sertoli cells after six hours, and loss of Leydig cells after 10 hours of complete absence of vascular flow. Clinically, 10 hours of torsion greater than 360 degrees will result in testicular atrophy for most patients. […] The likelihood that a torsed testis will remain viable is inversely related to the time elapsed between symptom onset and detorsion. A published series including 1140 patients found the risk of undergoing orchiectomy to be 5%, 20%, 40% 16%, and 90% at 0-6, 7-12, 13-18, 19-24, longer than 24, and longer than 48 hours after symptom onset, respectively.

• #25 Testicular torsion – Wikipedia

  https://en.wikipedia.org/wiki/Testicular_torsion

  Severe testicular pain, elevated testicle. […] The most common symptom in children is sudden, severe testicular pain. The testicle may be higher than usual in the scrotum and vomiting may occur. […] Testicular torsion usually presents with severe testicular pain or pain in the groin and lower abdomen. Pain generally begins suddenly and typically involves only one side. There is often associated nausea and vomiting. […] Quick recognition of worrisome symptoms is essential to preventing delayed presentation and subsequently losing a testicle. […] If treated either manually or surgically within six hours, there is a high chance (approximately 90%) of saving the testicle. At 12 hours the rate decreases to 50%; at 24 hours it drops to 10%, and after 24 hours the ability to save the testicle approaches 0, although salvage of the testicle has been reported beyond 24 hours.

• #26 Testicular Torsion: Diagnosis, Evaluation, and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/1215/p835.html

  There is typically a four- to eight-hour window before significant ischemic damage occurs, manifested by morphologic changes in testicular histopathology and deleterious effects on spermatogenesis. […] Reported testicular salvage rates are 90% to 100% if surgical exploration is performed within six hours of symptom onset, decrease to 50% if symptoms are present for more than 12 hours, and are typically less than 10% if symptom duration is 24 hours or more.

• #26 Testicular Torsion: Diagnosis, Evaluation, and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/1215/p835.html

  Testicular torsion is a twisting of the spermatic cord and its contents and is a surgical emergency affecting 3.8 per 100,000 males younger than 18 years annually. […] Testicular torsion is a clinical diagnosis, and patients typically present with severe acute unilateral scrotal pain, nausea, and vomiting. […] There is typically a four- to eight-hour window before permanent ischemic damage occurs. Delay in treatment may be associated with decreased fertility, or may necessitate orchiectomy. […] The classic presentation of testicular torsion is sudden onset of severe unilateral testicular pain associated with nausea and vomiting. […] In cases of intermittent torsion, patients typically report recurrent episodes of acute unilateral scrotal pain. […] Prompt restoration of blood flow to the ischemic testicle is critical in cases of testicular torsion, and prompt referral to a urologist is recommended.

• #27 Degree of twisting and duration of symptoms are prognostic factors of testis salvage during episodes of testicular torsion – Howe – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/16891/html

  If surgical exploration is delayed, testicular atrophy will occur by 6 to 8 h, with necrosis ensuing within 8 to 10 h of initial presentation. Salvage rates of over 90% are seen when surgical exploration is performed within 6 h of the onset of symptoms, decreasing to 50% when symptoms last beyond 12 h. The chance of testicular salvage is less than 10%, when symptoms have been present for over 24 h. […] We were able to derive separate formulas to determine the viability of the torsed testis based on symptom duration and degrees of twisting. Fifteen h of symptoms and 860 degrees of torsion gives testes a 50% salvage rate. […] Duration of symptoms appeared to be the primary predictor of outcomes. […] Our study is also the first to derive separate formulas for duration and degree of twisting to determine the probability of a non-salvageable testis during torsion episodes. This probability can be calculated by our formulas, 4 + (3 duration in hours) and 7 + (0.05 degree of twisting). […] The viability of the torsed testis can be determined by the duration of symptoms along with degree of twisting, with 15 h of symptom duration and 860 degrees of torsion leading to a 50% probability of non-salvage.

• #28 Testicular Torsion: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15382-testicular-torsion

  The outlook for testicular torsion is good if you get treatment right away within six hours. […] However, if you dont have blood flow to your testicle for more than six hours, your testicle may lose its ability to function. If this happens, a surgeon will need to remove it. […] If you dont get treatment right away within six hours testicular torsion can permanently damage (infarct) your testicle. A surgeon will remove the damaged testicle if a torsion doesnt receive treatment in time.

• #29 Testicular torsion in teenagers – information for parents/carers | CUH

  https://www.cuh.nhs.uk/patient-information/testicular-torsion-in-teenagers-information-for-parentscarers/

  Suspected testicular torsion requires emergency surgery. Your child will be asleep for the operation under a general anaesthetic. […] […] It may be necessary to remove the affected testicle during surgery (called orchidectomy) if the damage caused by the twisting is considered to be irreversible and the affected testicle is therefore not viable (dead.) […] […] Although fertility will not be known at your sons age, one testicle is also sufficient for fertility so having only one testicle does not tend to cause long-term problems.

• #30 Testicular torsion: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000517.htm

  The testicle may shrink if blood supply is cut off for an extended time. It may need to be surgically removed. Shrinkage of the testicle may occur days to months after the torsion has been corrected. Severe infection of the testicle and scrotum is also possible if the blood flow is limited for a long period.

• #31 Testicular torsion Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/testicular-torsion

  The testicle may shrink if blood supply is cut off for an extended time. It may need to be surgically removed. Shrinkage of the testicle may occur days to months after the torsion has been corrected. Severe infection of the testicle and scrotum is also possible if the blood flow is limited for a long period.

• #32

  https://nuhsplus.edu.sg/article/keep-your-family-jewels-safe–understanding-testicular-torsion

  This rare but serious condition is often mistaken for stomach ailments. If not treated promptly, it can have severe consequences. […] One condition that requires urgent attention is testicular torsion. This occurs when the spermatic cord a bundle of vessels, nerves and ducts connected to the testes twists, cutting off the blood supply to the testicle, explained Dr Chong Weiliang, Consultant, Department of Urology, National University Hospital (NUH). […] Symptoms of testicular torsion include sudden and severe testicular pain that sets in over several hours, as well as swelling, nausea and vomiting. The testicle may feel warm and tender, and an ultrasound might reveal poor blood flow to the affected area. […] Dr Chong noted that delays in treatment can lead to severe testicular damage. This can potentially affect fertility and lower hormone production in the long run. Timely treatment for testicular torsion is crucial to prevent complications such as loss of the testicle or reduced fertility, he stressed.

• #33

  https://nuhsplus.edu.sg/article/keep-your-family-jewels-safe–understanding-testicular-torsion

  Treatment for testicular torsion usually involves surgery to untwist the cord and restore blood flow. The testicle is then stitched in place to the surrounding tissues to prevent a recurrence of the twisting. […] Fortunately, even losing one testicle will not result in infertility if the remaining testicle is healthy, said Dr Chong. However, it can reduce overall hormonal production and semen quality due to reduced sperm production, he added.

• #34 Testicular Torsion: Causes, Symptoms, and Treatment

  https://patient.info/mens-health/scrotal-lumps-pain-and-swelling/torsion-of-the-testis

  Occasionally, the symptoms are milder. […] A testis with its blood supply cut off is likely to die unless the blood flow is quickly restored. […] If the blood supply to your testis is cut off for more than about six hours then permanent damage is likely to occur. […] The sooner the operation is done, the better the outlook to save your testis. Ideally, the operation should be done within 6-8 hours of symptoms starting. […] Some boys and men have warning pains in a testicle (testis) every now and then, before a full-blown twisting (torsion). These occur suddenly, last for a few minutes, then ease just as suddenly. […] Both how badly the testis has twisted and how long it stays twisted for are important in the outcome. If correcting surgery happens within six hours of torsion, 9 or 10 out of 10 testes will be saved on average. If surgery is delayed until between 12 hours and 24 hours from the start of symptoms then only one testis is saved out of 10.

• #35

  https://www.singhealth.com.sg/patient-care/conditions-treatments/testicular-torsion

  Pain in the testicles the pain is usually severe and occurs suddenly. […] Sometimes the pain is felt over lower abdomen and mistaken as abdominal pain (tummy pain). […] Nausea or vomiting. […] Swelling and redness over the testicle and the skin of the scrotum (the sac that contains the testis). […] Testicular torsion is an EMERGENCY. […] If you / your child experience any sudden onset of pain in the testicle / scrotum, especially if it is accompanied by redness and swelling, you / your child should IMMEDIATELY seek medical attention at a hospitals Emergency Department. […] Any delay in seeking medical treatment may lead to permanent damage to the testicle. […] Thankfully, if this is caught early and treatment is given, the chances of a full recovery is very high.

• #36

  https://journals.lww.com/md-journal/fulltext/2023/05050/atypical_symptoms_of_testicular_torsion_in_a.8.aspx

  Testicular torsion accounting for 25% of acute scrotal disease, is an acute surgical condition. A 7-year-old boy was admitted to the pediatric emergency department with continuous and progressive left scrotal pain for 2 days, associated symptoms and signs included left scrotal swelling and erythema. The pain started 4 days ago as left lower abdominal pain which then migrated to the left scrotum. Physical examination showed left scrotum skin redness, swelling, local heat, tenderness, high-riding testis, absence of the left side cremasteric reflex and a negative Prehns sign. Symptoms of testicular torsion may be atypical, especially in prepubertal age. Testicular torsion is diagnosed clinically with symptoms of abrupt onset testicular or scrotal pain, scrotal swelling, nausea, and vomiting. The most common atypical symptoms are lower abdominal pain, inguinal pain, and nausea/vomiting. Prepubertal children are more likely to present with atypical symptoms than post pubertal children, resulting in delayed diagnosis and intervention. For maximizing the chances of testicular survival, prompt diagnosis and treatment of testicular torsion is crucial.

• #37 Testicular Torsion – Core EM

  https://coreem.net/core/testicular-torsion/

  Sudden onset of scrotal pain […] Up to 20% of patients will have abdominal or flank pain alone (Mellick 2012) […] Nausea and vomiting […] History of blunt trauma (~ 10% of patients) […] History of similar pain in the past […] Presentation is often delayed (mean time to presentation 9.5 hours) (Rosens) […] Duration of symptoms should NOT guide management […] Historically, believed that symptoms 24 hours inconsistent with salvageable tissue […] However, testicle may torse + detorse making it difficult to know how long ischemia present […] Unilateral tender, firm testicle […] Scrotal erythema, edema and swelling […] Affected testicle typically higher than the unaffected one. OR = 58.8 (Ben-Israel 2010) […] Loss of cremasteric reflex […] Horizontal (instead of vertical) testicular lie

• #38 Testicular Torsion

  https://mobile.fpnotebook.com/Uro/Testes/TstclrTrsn.htm

  Sudden severe unilateral Scrotal Pain (thunder-clap pain) […] Presentation is within 24 hours in majority of cases (OR 4.2), and typically within 12 hours […] Testicular Torsion is cause of sudden unilateral Scrotal Pain in 16-42% of boys […] Intermittent pain may occur if the Testicle recurrently torses and detorses […] Painless Testicular Torsion may occur (if nerve is ischemic on twisting with vascular supply) […] Pain typically returns due to inflammation related to infarct of the Testicle […] Nausea or Vomiting (OR 8.9, occurs in 90% of patients) […] Lower Abdominal Pain or inguinal pain […] Infants may present only with unconsolable crying […] May present only with painless Scrotal Swelling […] Pain may have improved or resolved at presentation despite persistent Testicular Torsion

• #39 Testicular Pain: Causes, Sides, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/symptoms/16292-testicular-pain

  Testicular torsion is when the spermatic cord twists and cuts off blood flow to a testicle usually your left testicle. It causes a sudden sharp pain. It can occur at any time. Testicular torsion is a medical emergency that requires surgery. […] Go to an emergency room (ER) if you have intense testicular pain. It could be a sign of testicular torsion, which is a serious medical emergency. […] Talk to a healthcare provider or go to the ER immediately if you have: Sudden, intense pain in one or both of your testicles. […] Testicular pain that lasts for more than an hour or doesn’t get better while you’re resting or lying down. […] You should immediately call a healthcare provider if you have testicular pain or swelling, especially if the pain gets worse or if you feel sick. If you have testicular torsion symptoms, make sure to get to an emergency room as soon as possible.

• #40 Testicular Torsion | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/testicular-torsion

  Testicular torsion causes severe testicular pain and usually occurs in boys 10 years and older. […] Take your child to the emergency department immediately if he experiences any of the following symptoms: Scrotal pain that develops suddenly, Increasing scrotal pain despite treatment with pain medication, Redness and swelling of the scrotum, Scrotal pain with abdominal pain, nausea or vomiting, High-lying testicle, Bruising or firmness of the scrotum in newborns. […] The sooner your child is taken to the emergency department after the pain begins, the less likely the testicle will need to be removed.

• #41 Testicular Torsion (for Teens) | Nemours KidsHealth

  https://kidshealth.org/en/teens/torsion.html

  Testicular torsion is an emergency: When it happens, a guy needs surgery fast. Saving the testicle becomes more difficult the longer the spermatic cord stays twisted. […] Ignoring pain for too long or simply hoping it goes away can result in severe damage to your testicle and might lead to your testicle being removed. […] A torsion that goes away makes you more likely to have another one later.

Zobacz więcej