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Given the treatment implications of testicular torsion, it is important to distinguish testicular torsion from other causes of testicular pain, such as epididymitis, which can present similarly. While both conditions can cause testicular pain, the pain of epididymitis is typically localized to the epididymis at the rear pole of the testicle.
The differential diagnosis of testicular pain is broad and involves conditions from benign to life-threatening. The most common causes of pain in children presenting to the emergency room are testicular torsion (16%), torsion of a testicular appendage (46%), and epididymitis (35%). [4] In adults, the most common cause is epididymitis. [citation ...
Orchiopexy is performed in the event of testicular torsion, a urologic emergency presenting with intense pain and often without inciting injury. [citation needed]While neonatal torsion occurs with no anatomic defect to account for its occurrence (occurring in utero or shortly after birth), adult torsion results from a bilateral congenital anomaly often called a "bell-clapper deformity", where ...
Chronic testicular pain is long-term pain of the testes. [ 2 ] [ 3 ] It is considered chronic if it has persisted for more than three months. [ 1 ] Chronic testicular pain may be caused by injury , infection , surgery , cancer , varicocele , or testicular torsion , and is a possible complication after vasectomy . [ 2 ]
Therefore, testicular torsion is a surgical emergency and the role of ultrasound is to differentiate it from epididymitis as both disease presents with acute testicular pain clinically. [citation needed] There are two types of testicular torsion: extravaginal and intravaginal. Extravaginal torsion occurs exclusively in newborns.
Conditions that may result in similar symptoms include testicular torsion, inguinal hernia, and testicular cancer. [1] Ultrasound can be useful if the diagnosis is unclear. [1] Treatment may include pain medications, NSAIDs, and elevation. [1] Recommended antibiotics in those who are young and sexually active are ceftriaxone and doxycycline. [1]
According to Prehn's sign, the physical lifting of the testicles relieves the pain of epididymitis but not pain caused by testicular torsion. [4] Negative Prehn's sign indicates no pain relief with lifting the affected testicle, which points towards testicular torsion which is a surgical emergency and must be relieved within 6 hours.
Testicular torsion is a condition of physical twisting of the testis which results in cutting off the blood supply. It leads to damage that, if not treated within a few hours, causes the death of testicular tissue, and requires removal of the testis to prevent gangrene, and therefore can cause infertility. [82]