Hello and welcome to the Zero Definals podcast.

My name is Tom and in this episode I'm going to be talking to you about testicular torsion.

And you can find written notes on this topic at zero definals.com slash testicular torsion

or in the urology section of the Zero Definalsinals surgery book. So let's get straight into it.

Testicular torsion refers to twisting of the spermatic cord with rotation of the testicle. It's a

urological emergency and a delay in treatment increases the risk of ischemia and necrosis of the testicle,

which can lead to subfertility or infertility.

There's an urgent need to take action, otherwise it could lead to death of the testicle and

infertility.

The typical patient is a teenage boy, but testicular torsion can occur at any age.

There may be a history of recurrent symptoms in patients where there is intermittent testicular torsion,

where the testicle twists and untwists intermittently.

Let's talk about the presentation.

Testicular torsion is often triggered by some sort of activity,

such as playing sports. Ask what the patient was doing at the time when the pain started,

as you may be able to identify a trigger. It presents with an acute, rapid onset of unilateral

testicular pain, pain in one testicle, and there may be

associated abdominal pain and vomiting. Sometimes abdominal pain is the only symptom in boys,

and testicular examination to exclude torsion is essential. The examination findings with

a testicular torsion are a firm, swollen testicle,

an elevated or retracted testicle, absence of the cremasteric reflex, abnormal testicular lie,

often with a horizontal testicle, and rotation so that the epididymus is not in the normal posterior

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