2023-10-13 10:42:00
Testicular torsion is a common acute genital anomaly that affects more than one in ten men, generally following birth, during early childhood or at puberty (often while the organ still lacks fixity). She needs rapid surgery.
Definition: what is testicular torsion?
This absolute medical emergency corresponds to a torsion of the spermatic cord to which the testicle is connected scrotum inside the scholarships. Indeed, this cord contains blood vessels (called “spermatic”). Thus its twisting is responsible for an interruption of blood circulation. In the absence of treatment (and if the torsion does not resolve spontaneously), the survival of the organ is compromised.
Testicular torsion is more often unilateral, although it can involve both testicles. This anomaly preferentially affects the left testicle.
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Causes of testicular torsion: when, how and why does it happen to me?
Testicular torsion can be the consequence of:
- a congenital anomaly (poor fixation of the testicle, cord too long, lack of connection of the vagina, etc.);
- a rapid increase in the volume of the testicle at the time of puberty responsible for a disproportion between the testicular volume and the fixation zones.
Testicular torsion is a mechanical reaction, it can happen at any time of the day (during usual activity) or night (during sleep).
Pain, swelling, nausea: what are the symptoms of testicular torsion?
It is important to recognize the signs of testicular torsion so that you can act quickly to avoid compromising the survival of the organ.
Torsion of a testicle in adolescents and adults: what are the signs?
Manifestations can occur during the day while the patient is carrying out their usual activities or even during the night. Sometimes testicular pain can be warning signs in the weeks before the episode.
- a severe pain in one or both testicles. This pain worsens over the hours, radiating towards the groin and lower back;
- and swelling and an induration a scholarship or both;
- a difficulty walking ;
- of the nausea and vomiting;
- vagal discomfort:
- a frequent urge to urinate is possible (pollakiurie).
How to recognize testicular torsion in babies?
- Of the cris and tearsunusual;
- and swelling and an redness in one or both testicles.
Sometimes at birth, it happens that the infant presents with brownish purse or purplish et indurated.
Consequences of torsion: a risk of necrosis?
The main risk is the necrosis of the testicle following 6 hours of twisting. In the longer term, when the testicle is destroyed, the risk is infection of the contents of the purse and the source of the testicle. The patient might then present a atrophied testicle and an potentially unsightly asymmetry and which might have a slight impact on his fertility (although a single testicle is sufficient for acceptable production of hormones and sperm).
Testicular torsion: what to do? how is the diagnosis made?
In the event of signs suggestive of testicular torsioncontact as soon as possible the 15 where the 112 or go to the emergency department of your local hospital.
A simple one physical examination will allow the doctor to initiate treatment. Sometimes a color duplex ultrasound can be performed in case of diagnostic doubt.
Treatments: how to treat testicular torsion?
L’intervention chirurgicale is essential in order to save the organ. During this procedure, the testicle is rotated back into place. Then, it is necessary to fix the testicle to the scrotum using a thread in order to avoid recurrences (orchidopexie). This procedure is performed on both testicles as a preventive measure.
In the weeks following the operation, the testicle may shrink or disappear (atrophy). Patients who undergo the procedure too late and who present with necrosis must have the testicle surgically removed (orchidectomie). However, if this situation affects the newborn who suffered testicular torsion during pregnancy, the testicle is preserved despite its condition because the tissues are likely to regenerate. In all these cases, it will be possible to later install a silicone prosthesis in the event of asymmetry for aesthetic reasons.
After the procedure, medical supervision is essential.
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