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Testicular torsion may also be caused by trauma to the scrotum or exercise (in particular, bicycle riding); [10] however, only about 4–8% of cases are the result of trauma. [1] [2] There is thought to be a possible genetic basis for predisposition to torsion, based on multiple published reports of familial testicular torsion. [10]
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.
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.
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 ...
The most frequent clinical presentation occurs when a routine physical examination yields an unexpected finding, which is then confirmed by scrotal ultrasonography. [1] Although the exact cause of epididymal cysts is unknown, it is likely a congenital anomaly associated with hormonal imbalances during the embryonic stage of development. [3]
Testicular torsion may result in irreversible damage to the testicle within hours. A collection of serous fluid in the spermatic cord is named 'funiculocele'. The contents of the abdominal cavity may protrude into the inguinal canal, producing an indirect inguinal hernia
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 ...
However, as torsion and other sources of testicular pain can often be determined by palpation alone, some studies have suggested that the only real benefit of an ultrasound is to assure the person that they do not have testicular cancer. [14]: p.237 Nuclear testicular blood flow testing is rarely used. [citation needed]