Testicular torsion and its effects on contralateral testicle

Barkley, Craig; York, Jeffrey E.; Badalament, Robert A.; Nesbitt, John A.; Smith, Jeffrey J.; Drago, Joseph R.

doi:10.1016/0090-4295(93)90180-i

Cited by 18 publications

(7 citation statements)

References 8 publications

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“…Second, several studies have disclosed that if a twisted testis is not removed, a reduced sperm count is not uncommon. [17][18][19][20] In our study, the pain duration was significantly different between groups. Testicular ischemia typically presents with sharp pain and epididymo-orchitis presents with indolent or slowly progressive pain.…”

Section: Resultscontrasting

confidence: 46%

Usefulness of Ultrasound in Acute Scrotum

Malagi¹,

Rathinasamy²,

Nedunchelian³

et al. 2014

jemds

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To find out real incidence of TT in pediatric age group as against EO. BACKGROUND: Acute painful scrotum is one of the most challenging urological emergencies. The early and accurate diagnosis of testicular torsion remains a clinical challenge and it accounts for approximately 25% to 35% of patients presenting with acute scrotum 1. To date, no single reliable clinical feature or examination can give 100% diagnostic accuracy 2. Though these problems are rare in pediatric age group, they pose a serious risk of loss of vital functions of testis. Torsion (TT) is not uncommon-a fact unknown to most pediatricians & general practitioners. Testicular torsion has a lifetime incidence of approximately 1/4000 males younger than 25 years 3. This disease affects a wide age range, and most commonly occurs between the ages of 12 and 18 years, after which the incidence slowly decreases 4. Early diagnosis leads to preservation & its endocrine function & fertility. Hence as it is very difficult to differentiate TT & Epididymo-orchitis (EO) clinically, all cases should be submitted for surgical exploration at the earliest. METHODS: A Total of 250 patients were observed. All cases in the concerned age group presenting with acute pain, swelling in the scrotum, fever, vomiting were examined. Those having inflammatory signs in scrotum or any other signs suggesting TT or EO were admitted & evaluated. CONCLUSION: As the loss of gonadal function occurs so rapidly in TT, surgical exploration should neither be delayed for sonography nor be denied because of negative imaging in all acute scrotal swelling cases.

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Section: Resultscontrasting

confidence: 46%

Usefulness of Ultrasound in Acute Scrotum

Malagi¹,

Rathinasamy²,

Nedunchelian³

et al. 2014

jemds

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“…Deterioration of this regular blood flow to a testicle due to various pathologies will in turn pro duce contralateral testicular histological alterations and diminished fertility [15][16][17], Despite the fact that several possible etiologic factors have been proposed, no clear reason for the histological deterioration of the contralater al testis has been found to date. However, one of the uni versally accepted mechanisms for such an alteration is the reflexive decrease in contralateral testicular blood flow [3,9], Electromagnetic and radioisotopic blood flow mea surements have shown a considerable decrease in contra lateral testicular perfusion following long-term unilateral testicular torsion [3,9], On the other hand, studies in this field revealed that torsion produces an immediate and then a progressive decrease in the contralateral blood flow, while detorsion is followed by a gradual increase in blood flow, which is called reactive hyperemia of the tis sue.…”

Section: Discussionmentioning

confidence: 99%

Influence of Experimental Spermatic Cord Torsion on the Contralateral Testis in Rats

Sarıca¹,

Küpeli

Budak³

et al. 1997

Urol Int

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To evaluate the degree of ischemia formation in the contralateral testicle following unilateral testicular torsion, free oxygen radical formation after detorsion or an orchiectomy procedure in terms of superoxide dismutase (SOD) and catalase activities was detected in adult male Wistar rats. Animals were divided into 4 groups and following 2 and 6 h of unilateral torsion, the orchiectomy or detorsion procedures were performed and free radical scavenger enzyme activities (SOD, catalase) were measured in the contralateral testes after 24 h, 1 week and 1 month. Evaluation of our results revealed no meaningful ischemia formation in the contralateral testes of rats undergoing 2 h of unilateral testicular torsion. However, animals undergoing 6 h of unilateral testicular torsion demonstrated a statistically significant alteration with respect to enzyme concentrations. Alterations in the contralateral testes were more prominent in animals that had undergone the detorsion procedure following 6 h of testicular torsion. Our results indicate that preservation of twisted testes through a detorsion procedure could cause further deterioration by way of reperfusion injury, indicating the importance of removal of the damaged testicle to minimize long-term histopathologic alterations in the contralateral testes.

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“…Second, several studies have disclosed that if a twisted testis is not removed, a reduced sperm count is not uncommon. (11)(12)(13) In our study, the pain duration was significantly different between groups. Testicular ischemia typically presents with sharp pain and epididymo-orchitis presents with indolent or slowly progressive pain.…”

Section: Discussionmentioning

confidence: 69%

The dilemma in the diagnosis of acute scrotum: clinical clues for differentiating between testicular torsion and epididymo-orchitis

Yu¹,

Wang²,

Chen³

et al. 2012

Biomed J

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Background: Acute painful scrotum is one of the most challenging urological emergencies.Irreversible parenchymal damage will develop if a testicle is twisted. The aim of the study was to determine the importance of different clinical clues to help differentiate the causes of this devastating condition. Methods:The medical charts of teenagers with acute scrotal pain between January 2003 and December 2008 were reviewed retrospectively. Results:Seventy-six patients were included in this study, including 47 initially suspected of having testicular torsion and 29 suspected of having epididymoorchitis. Testicular torsion was confirmed in 39 of the suspected 47 cases after surgical exploration. Twnety-one of these 39 testicular torsion patients underwent orchiectomy, and 18 were rescued and underwent orchiopexy. The mean pain duration was significantly longer in the orchiectomy group than the orchiopexy group (38.05 hours vs 14.14 hours, p = 0.009). In the testicular torsion group, fewer patients had elevated C-reactive protein levels no patients had pyuria, and the pain duration was shorter compared with the epididymo-orchitis group (

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Testicular torsion and its effects on contralateral testicle

Cited by 18 publications

References 8 publications

Usefulness of Ultrasound in Acute Scrotum

Usefulness of Ultrasound in Acute Scrotum

Influence of Experimental Spermatic Cord Torsion on the Contralateral Testis in Rats

The dilemma in the diagnosis of acute scrotum: clinical clues for differentiating between testicular torsion and epididymo-orchitis

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