Testicular torsion - wd1
Classification & external resources

ICD-10	N44.
ICD-9	608.2
OMIM	187400
DiseasesDB	12984
eMedicine	med/2780
MeSH	D013086

In testicular torsion the spermatic cord that provides the blood supply to a testicle is twisted, cutting off the blood supply, often causing orchalgia. Prolonged testicular torsion will result in the death of the testicle and surrounding tissues. Image File history File linksMetadata Illu_testis_surface. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // N00-N39 - Diseases of the genitourinary system: urinary system (N00-N08) Glomerular diseases Prefixes: .2 Diffuse membranous glomerulonephritis (N00) Acute nephritic syndrome (N01) Rapidly progressive nephritic syndrome (N02) Recurrent and persistent haematuria (N03) Chronic nephritic syndrome (N04) Nephrotic syndrome Lipoid nephrosis (N05) Unspecified nephritic syndrome (N06) Isolated proteinuria with specified... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Male Anatomy The spermatic cord is the name given to the cord-like structure formed by the vas deferens and surrounding tissue (veins, arteries, nerves, and lymphatic vessels) that run from the abdomen down to each testicle. ... Look up testes in Wiktionary, the free dictionary. ... Orchalgia is chronic pain of the testicles or scrotum that typically lasts for more than three months. ...

It is also believed that torsion occurring during fetal development can lead to the so-called neonatal torsion or vanishing testis, and is one of the causes of an infant being born with monorchism. Vanishing testis refers to the disappearance of one or other testis during embryonic or foetal development. ... Monorchism is the state of having only one testicle within the scrotum. ...

Risk factors

In most males, the testicles are attached to the inner lining of the scrotum. Males whose attachment is higher up are at risk of testicular torsion. This condition is known as a bell clapper deformity (as in the central piece of a bell) and is a major cause of testicular torsion. A male who notices the ability of either or both testicles to freely rotate within the scrotum should be aware that he is at risk of testicular torsion. Testicles that are in a much lower position and/or in a slightly rotated position in the scrotal sack are a visual indicator of this risk.

Torsions are sometimes called "winter syndrome". This is because they often happen in winter, when it is cold outside. The scrotum of a man who has been lying in a warm bed is relaxed. When he arises, his scrotum is exposed to the colder room air. If the spermatic cord is twisted while the scrotum is loose, the sudden contraction that results from the abrupt temperature change can trap the testicle in that position. The result is a testicular torsion.

Prevalence

While torsion is more frequent among adolescents, it should be considered in all cases where there is testicular pain. Torsion occurs more frequently in patients who do not have evidence of inflammation or infection. Two risk factors are trauma and strenuous physical activity.

Diagnosis

Emergency testing for torsion may be indicated when the onset of pain is sudden and/or severe, or the test results available during the initial examination do not enable a diagnosis of urethritis or urinary tract infection to be made. A doppler ultrasound scan of the scrotum, if available, is of immense help in the diagnosis by showing the presence or absence of blood flow to the testicle. Dizziness and nausea are often present when there is an absence of blood supply to the testicle, as well as a tremendous amount of pain. If the diagnosis is questionable, an expert should be consulted immediately, because testicular viability may be compromised. If physical examination suggests a compromised blood supply and the patient has had such symptoms for a significant period of time, medical personnel may choose to bring the patient directly to surgery without an ultrasound since the time required for ultrasound testing could affect testicular viability. Urethritis is an inflammation of the urethra. ... A urinary tract infection (UTI) is a bacterial infection that affects any part of the urinary tract. ... For other uses, see Ultrasound (disambiguation). ...

Color Doppler sonography is used to identify the absence of blood flow typically found in a twisted testicle, which distinguishes the condition from epididymitis. ^[1] Epididymitis is a medical condition in which the epididymis becomes inflamed. ...

Urinalysis (analyzing chemical composition of urine) can be used to rule out bacterial infections. A urinalysis (or UA) is an array of tests performed on urine and one of the most common methods of medical diagnosis. ... Phyla/Divisions Actinobacteria Aquificae Bacteroidetes/Chlorobi Chlamydiae/Verrucomicrobia Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Nitrospirae Omnibacteria Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Bacteria is also the fictional name of a warring nation under Benzino Napaloni as dictator, in the 1940 film The Great Dictator...

Surgical exploration may be necessary if diagnosis cannot be made using other methods. If there is the slightest hint of a torsion of the testicle, then doctors will perform surgery; even if the testicle turns out not to have twisted, they will still protect it by attaching the testicle to the scrotum wall.

Treatment

With prompt diagnosis and treatment the testicle can be saved in a high number of cases.^[2]

Testicular torsion is a medical emergency that needs immediate treatment. If treated within 6 hours, there is nearly a 100% chance of saving the testicle. Within 12 hours this rate decreases to 70%, within 24 hours is 20%, and after 24 hours the rate approaches 0. (eMedicineHealth) Once the testicle is dead it must be removed to prevent gangrenous infection. {{Otheruses4|the medical term|the Australian television series|Medical Emergenc an immediate threat to a persons life or long term health. ... Gangrene is the necrosis and subsequent decay of body tissues caused by infection or thrombosis. ...

A simple and minor surgery will correct and prevent testicular torsion. It can be done in an emergency situation after determination that the testicle is cut off from blood supply or as an outpatient procedure for patients who have experienced frequent episodes with testicular torsion. If necessary, the surgeon will first untwist the testicle(s). The surgeon will then permanently suture the testicles to the inner lining of the scrotum. If only one testicle has been problematic, the surgeon may suture both testicles as a preventative effort. “Surgeon” redirects here. ... For other uses, see Suture (disambiguation). ...

Trivia

• Testicular torsion is the subject of The Venture Bros. episode "Are You There, God? It's Me, Dean." The subject is now a running gag of sorts and is allegedly inspired by writer Doc Hammer's real-life experience with the affliction.

The Venture Bros. ... This article does not cite any references or sources. ... This article contains a trivia section. ...

References

1. ^ Arce J, Cortés M, Vargas J (2002). "Sonographic diagnosis of acute spermatic cord torsion. Rotation of the cord: a key to the diagnosis.". Pediatr Radiol 32 (7): 485-91. PMID 12107581. 
2. ^ Cattolica E, Karol J, Rankin K, Klein R (1982). "High testicular salvage rate in torsion of the spermatic cord.". J Urol 128 (1): 66-8. PMID 7109074. 

External links

Adapted from the public domain document Centers for Disease Control and Prevention. 1998 Guidelines for Treatment of Sexually Transmitted Diseases. MMWR 1998;47(No. RR-1) at http://wonder.cdc.gov/wonder/STD/STD98TG/STD98T12.HTM and other sources.