Renal & UrologyPending review

Testicular Torsion

Twisting of the spermatic cord that first occludes venous return and then arterial supply, producing an ischaemic time bomb in which every hour of delay costs testicular viability: a clinical diagnosis demanding immediate surgical exploration.

In a nutshell

The bell-clapper deformity lets the testis rotate on its cord, occluding low-pressure venous return first and high-pressure arterial inflow second. Ischaemia is time-dependent: salvage falls sharply after about six hours. Torsion is a clinical diagnosis and a surgical emergency: never delay exploration for imaging.

Classic presentation

A peripubertal boy or young man with sudden severe unilateral testicular pain, nausea and vomiting, and a high-riding, swollen, tender testis with an absent cremasteric reflex.

Key points

Torsion is a clinical diagnosis: do not delay surgical exploration for a Doppler ultrasound if suspicion is high.

You’ve reached the end of the preview

This topic is part of full high-yield access. Create a free account to read every key point, first-line investigation and exam trap — or browse the free sample topics without one.

Educational content pending clinical review. Not medical advice.