Torsion of testicle
- Occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum
- Typically in teenage boys, but can occur at any age
- Bell clapper deformity is a predisposing factor - insertion of the tunica vaginalis is high, meaning testis can rotate and even sit laterally
Clinical features
- Sudden, severe, testicular pain (in the groin and lower abdomen) and tenderness
- There is often associated nausea and vomiting
- The testis may be higher than its normal position
- Mild pyrexia and redness of overlying area may be found
- The cremasteric reflex is often reduced or absent
Management
Epididymoorchitis
- Inflammation of the testis and epididymis secondary to infection
- In <35s, the most common causes are STIs (e.g. N. Gonorrhoea)
- In those over 35 years old, E. coli - originating from the GI tract - is the most common cause
Clinical features
- Acute onset, severe testicular pain
- Patient may feel unwell and have a history of dysuria and urethral discharge (due to an STI)