A. Inversion of the testis is the most common predisposing cause
B. Pyuria may be present
C. Doppler U/S shows decreased blood flow to the testis
D. Simultaneous orchipexy of the other side should also be done.
Ans:B. Pyuria may be present
Torsion of the testis is shown in the image
TORSION OF THE TESTIS
- For torsion to occur one of the several abnormalities must be present
- Inversion of the testis is the most common predisposing cause
- High investment of tunica vaginalis (testis hangs like clapper in bell).
- Bell-clapper deformity—poor gubernacular fixation of the testicles to the scrotal wall
- Straining at stool
- Lifting heavy weight
- Sometimes spontaneously during sleep
- Most common between 10 and 25 years of age. Few cases occur in infancy
- Most common cause of testicular pain >12 years
- Sudden agonizing pain in the groin and lower abdomen, nausea, vomiting.
- Pyuria is associated with epidydimo-orchitis, not with torsion of testis
- Deming’s sign: affected testis is positioned high because of twisting of cord and spasm of cremaster muscle
- Angell’s sign; Opposite testis lies horizontally because of presence of mesorchium
- Prehn’s sign: on elevation of testis
- Pain decreases epididymorchitis
- Pain increases torsion
- Doppler ultrasound scan will confirm the absence of blood supply to the affected testis. But if diagnosis is doubt, the scrotum should be explored without delay.
- If the diagnosis of testicular torsion is possible, then surgical exploration is indicated
- Prompt exploration, untwisting and fixation is the only way to save the torted testis
- Anatomical abnormality is bilateral and the contralateral testis should also be fixed