Testicular torsion

Abstract

Testicular torsion is defi ned as an acute rotation of testis and spermatic cord with subsequent reduction or interruption of the blood fl ow. Left untreated a hemorrhagic infarction and necrosis of testicular tissue can be anticipated within 6-8 h depending on the extent of the ischemia. Although testicular torsion can occur at any age, there is peak incidence in the fi rst age and in the puberty. The estimated yearly incidence of testicular torsion for males younger than 18 years old is 3.8 per 100,000 with a 22-41.9 % rate of orchiectomy [ 1, 2 ]. The morbidity rate for testicular torsion is usually reported as 1 per 4,000 males until the age of 25 [ 1 ]. While the majority of the torsed testes are medially rotated, one-third are laterally rotated [ 3 ]. Trauma is not a common cause for testicular torsion as it often occurs without any precipitating events. Etiologically risk factors seem to be cold temperature, increased testicular volume or tumour, a history of cryptorchidism or late descent, a spermatic cord with a long intrascrotal portion and testicles with horizontal lie (e.g., bell-clap anomaly with its extremely wide movement radius within the testicular sheet) [ 4 ].