Bilateral testicular torsion in an adolescent: a case with challenging diagnosis

Hernández‐Lorenzo, Laura; Martínez-Cuenca, Esther; Broseta, Enrique

doi:10.1590/s1677-5538.ibju.2017.0371

Cited by 10 publications

(26 citation statements)

References 13 publications

(8 reference statements)

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“…Intravaginal torsion occurs because of anatomic abnormalities within the tunica vaginalis (eg, Bell‐Clapper deformity) and periods of testicular growth during puberty. 7 , 8…”

Section: Discussionmentioning

confidence: 99%

“…5 The annual incidence of testicular torsion in males under the age of 25 is 1 in 4000; 66% occur between the ages of 12 and 18 years with a peak incidence at 14 years. 5 , 7 , 8 , 9 , 10…”

Section: Discussionmentioning

confidence: 99%

“…and Washowich suggest, bilateral torsion can be misleading and must be considered within the differential diagnosis. 7 , 15 …”

Section: Discussionmentioning

confidence: 99%

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A rare case of bilateral testicular torsion in a 57‐year‐old man

et al. 2021

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Context Testicular torsion, the twisting of the testis or spermatic cord, places the testis at risk of vascular compromise and is a surgical emergency. Testicular torsion is predominantly unilateral (98% of torsion cases) and primarily affects neonates and adolescents in a bimodal distribution. Bilateral testicular torsion is exceedingly rare (2% of cases) and is associated with neonates. To the authors’ best knowledge, there have been no reports of bilateral torsion in adult males over the age of 24. Case details A 57‐year‐old man presented to the emergency department 9 days after developing testicular pain while lifting his lawnmower. Ultrasonography performed at an outside facility was unremarkable. He was encouraged to followup with urology as an outpatient. Despite outpatient analgesia, he continued to experience pain and returned to the ED, where repeat ultrasonography demonstrated bilateral torsion with hypoperfusion. Discussion Although testicular torsion is uncommon, the clinician must recognize torsion; if left untreated, torsion leads to infertility. Previous publications suggest that ultrasonographic findings of bilateral testicular torsion should be attributed to “technical failure” rather than a plausible diagnosis. However, this case demonstrates the importance of maintaining a high index of suspicion, especially with an atypical age range and pathological presentation, particularly among men during their reproductive years.

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“…Intravaginal torsion occurs because of anatomic abnormalities within the tunica vaginalis (eg, Bell‐Clapper deformity) and periods of testicular growth during puberty. 7 , 8…”

Section: Discussionmentioning

confidence: 99%

“…5 The annual incidence of testicular torsion in males under the age of 25 is 1 in 4000; 66% occur between the ages of 12 and 18 years with a peak incidence at 14 years. 5 , 7 , 8 , 9 , 10…”

Section: Discussionmentioning

confidence: 99%

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A rare case of bilateral testicular torsion in a 57‐year‐old man

et al. 2021

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“…Unilateral testicular torsion, which occurs most frequently during puberty, affects about one in 4000 boys. Bilateral torsion is much rarer, making the diagnosis difficult [ 1 ]. Strangulation of the blood supply is a medical emergency.…”

Section: Introductionmentioning

confidence: 99%

“My son was castrated as a result of a medical error. Is it OK to raise him as a eunuch?”

Johnson

Wassersug

2021

Annals of Medicine &Amp; Surgery

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A 12-year-old boy lost both testes after testicular torsion. He is now 14, and his father wants to know if the boy should immediately start supplemental testosterone or if he might reasonably choose to live as a eunuch. The boy does not yet express any strong opinion except that he is embarrassed about his weight gain. We advised the father that there is no need to rush the decision as the boy could at least delay testosterone therapy until his teens or early 20s and still go through male puberty with little risk of adverse health effects. We seek to know if others endorse our endocrinological advice. The boy's father wants to be honest with his son about the social challenges the boy may face if he elects to delay or avoid puberty altogether and chooses to openly identify as a eunuch.

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“…It is most common genitourinary tract emergency in children requiring urgent surgery. Bilateral testicular torsion is more common in neonates, however, in adolescent it occurs rarely, only five cases have been reported in the literature [1].…”

Section: Introductionmentioning

confidence: 99%