Medical notes (surgery)

Pic- coreem.net

Urology

Torsion testis

Predisposing factors

1. Long redundant spermatic chord
2. Invertion of testis
3. Sudden contraction of cremastric muscle
4. Epididymis separated from testis.

Types of testicular torsion

1. Extravaginal
2. Intravaginal

Clinical features
10- 25 (age)
Sudden agonizing Pain.
Empty scrotum on the affected side also edematous.

Signs
Deming's sign - tender lump at external ring
Prehns' sign- rising the scrotum increases pain.
Angells' sign- opposite scrotum is horizontal.

Management

Preferred detortioned in first 4 hours
First hour- manual detorsion
If it doesn't work explore the scrotum and detorsion is dome and its fixed to scrotum.
If the testis is necrosed  then remove it.
The other testis should be fixed to scrotum as soon as possible to prevent damage as its at risk.