Testicular torsion: symptoms, treatment, operation
Testicular torsion is a pathology that develops due to various reasons, which leads to twisting of the spermatic cord. The condition is dangerous because the treatment not started on time can lead to the development of necrosis against the background of the cessation of blood supply to the body of .The disease can occur in both an adult male and a child.At the initial stage of development, pathology can be eliminated without surgery.In advanced cases, only surgical treatment is shown, up to the complete removal of the organ.Table of contents:
Etiology of the disease
Factors that can lead to torsion of the testis:
- underdevelopment of the testicular ligament;
- prematurity of newborns;
- abnormal mobility of the organ, which may be due to improper fixation of the organ to the bottom of the scrotum;
- inguinal and scrotal hernia;
- pathology of development of genital organs;
- congenital pathology of the spermatic cord;
- morphofunctional immaturity of the genitourinary system;
- turning the body.
In rare cases, the disease can develop after surgery.
Regardless of the cause that led to the pathology, treatment should be immediate and be prescribed only by a specialist.Self-medication can lead to irreversible effects.
Classification of pathology
The development mechanism distinguishes two types of testicular torsion:
- intravaginal.Twisting of the spermatic cord occurs simultaneously with its shells;
- is extra-vaginal.Twisting occurs inside its own shell.
In some cases, there may be a torsion of testicular hydatids - a rudimentary process.
One-sided development of pathology is diagnosed more often than bilateral.
Symptoms of testicular torsion in children and adults
Clinical picture of torsion of testicle or hydatid:
- acute sudden pains in the scrotum;
- urination disorders;
- discomfort in the groin;
- nausea, sometimes resulting in vomiting;
- one side of the organ becomes smaller or larger;
- the scrotum acquires a cyanotic shade, or becomes pale;
- body feels hot;
- in neglected cases, the pain can be so strong that a man can not move normally.
Symptoms of testicular torsion in children:
- permanent crying;
- at the touch of the body the child begins to cry more strongly;
- elevated or subfebrile body temperature;
In the presence of such symptoms, an adult or child should immediately seek medical help from a specialist.
Surgical intervention and complications can be avoided if you seek help within the first 12 hours after the onset of the first symptoms.
The first thing the doctor performs is a thorough examination of the patient, with palpation of the diseased organ.Visually, there may be swelling and puffiness of the scrotum from the side of the affected testicle, a bluish tinge or pallor of the organ.
Research required for accurate diagnosis:
- puncture of the scrotum for microscopic examination of exudate;
- scrotal ultrasound;
- UZDG vessels of the organ.
The clinical picture is similar to other pathologies, therefore, differential diagnosis may be necessary to exclude or confirm the presence of diseases such as epididymitis, orchitis, Quincke's edema or hydrocele.
Based on the results of the study, the specialist puts the final diagnosis and selects the most appropriate treatment tactics.
When diagnosing pathology in the first 12 hours, external manual unwinding of the testicle is performed.If this method does not give a positive result, urgent surgical intervention is performed.
The operation is performed through the scrotal or inguinal access of the , depending on the location of the pathological process.It is important to assess the viability of the organ during the procedure.Reposition of the organ with its subsequent fixation to the tissues of the scrotum is carried out after the blood circulation is restored and the testicle acquires a natural color.
If the necrotic process begins, the testicle is removed completely .To prevent an aesthetic defect, an artificial body is implanted.
When diagnosing torsion, testicular hydatids are carried out by bandaging at the base, cutting and removing.
After the operation, the patient is prescribed a follow-up drug therapy, which includes antibiotics, analgesics and anti-inflammatory drugs, as well as physiotherapy procedures.Physical stress and sex during the rehabilitation period are excluded.
The use of traditional medicine and self-treatment is inappropriate, as this can lead to irreversible pathological processes.Drug treatment can only be prescribed by a specialist.
Complications that can develop without adequate timely treatment:
- organ necrosis;
- purulent inflammation;
Preventive measures to prevent the development of pathology:
- Avoid genital and groin injuries;
- Regular examination with urologist and surgeon;
- wearing free and comfortable underwear;
- with enhanced sports and physical activity use special protective equipment.
These elementary rules will prevent the development of pathology and avoid complications.
Radevich Igor Tadeushevich, the doctor of the sexopathologist-andrologist of 1 category