Nomogram predicting testicular torsion in Japanese patients with acute scrotal pain using physical examination findings and environmental conditions: Development and prospective external validation

Author(s):  
Hideki Takeshita ◽  
Kojiro Tachibana ◽  
Hironori Sugiyama ◽  
Makoto Kagawa ◽  
Akihiro Yano ◽  
...  
2019 ◽  
Author(s):  
Claudia Berrondo ◽  
Robert A. Mevorach ◽  
Jimena Cubillos

Testicular torsion is the most common pediatric urologic emergency and is a common cause of acute scrotal pain. Timely diagnosis is important for testicular salvage,as treatment delayed beyond 6 hours from the onset of symptoms is the most predictive factor of testicular death. There is a bimodal distribution of age with extravaginal torsion most commonly presenting in the neonatal period and intravaginal torsion most commonly presenting around the onset of puberty. Intermittent testicular torsion presents a unique challenge in making an accurate diagnosis, as patients most often present when asymptomatic. Several risk factors exist, although bell-clapper deformity is the most important. The diagnosis is made largely on history or physical examination. In equivocal cases, imaging with color Doppler ultrasonography may be helpful in making the diagnosis. Additional tools including near-infrared spectroscopy and Testicular Workup for Ischemia and Suspected Torsion score may be helpful in diagnosing testicular torsion. Possible long-term effects on fertility and hormonal function are also often a concern for the patient and clinician. This review contains 6 figures, 5 tables, and 34 references.  Keywords: acute, infarction, ischemia, orchidopexy, scrotum, spermatic cord, testis, torsion


PEDIATRICS ◽  
1986 ◽  
Vol 77 (6) ◽  
pp. 908-911
Author(s):  
Thomas J. Stillwell ◽  
Stephen A. Kramer

Testicular torsion is the most common cause of acute scrotal pain in prepubertal and adolescent boys and should be foremost in the minds of primary care physicians evaluating these children. Intermittent testicular torsion is a separate entity that should be considered in all young males with a history of scrotal pain and swelling. Acute and intermittent sharp testicular pain and scrotal swelling, interspersed with long intervals without symptoms, are characteristic. Physical findings may include horizontal or very mobile testes, an anteriorly located epididymis, or bulkiness of the spermatic cord from partial twisting. Awareness of this entity and early elective orchiopexy will improve testicular salvage in patients with intermittent testicular torsion.


2019 ◽  
Author(s):  
Jonathan E. Davis ◽  
Jeffrey S. Dubin

This review details the evaluation and management of the acute scrotum in the emergency department setting and emergent penile complaints in adults, with an emphasis on the most serious and most common conditions. Other emergent conditions include necrotizing fasciitis of the perineum (Fournier disease), incarcerated or strangulated inguinal hernia, and genitourinary (GU) trauma. Emergency practitioners need to be most concerned with the entities that, if left untreated, can result in ischemia and necrosis of the penis. Basic anatomy and bedside evaluation are reviewed. Acute scrotal and penile pain and GU trauma are discussed in terms of assessment and stabilization, diagnosis, and treatment and disposition.  This review contains 5 figures, 19 tables, and 71 references. Keywords: Acute scrotal pain, testicular torsion, priapism, Peyronie disease, paraphimosis, phimosis, balanitis, posthitis, epididymitis


2012 ◽  
Vol 8 (1) ◽  
pp. 18-22
Author(s):  
PK Chhetri ◽  
A Tayal ◽  
PK Deka

Based on physical examination alone it is often difficult to accurately make a clinical diagnosis and decide whether a palpable scrotal pathology arises from the testis itself or from extratesticular elements within the scrotum. Clinical examination of the testis is especially difficult due to pain, tenderness or when obscured by a large hydrocele. The aim of the study was thus undertaken to evaluate the role of ultrasonography (USG) in patients presenting with scrotal pain. 50 patients who presented to the surgical department with scrotal pain were subjected to USG. The commonest cause for scrotal pain was epididymitis with or without orchitis (40 %), followed in descending order by cystic lesions of the epididymis (18 %), varicocele (12 %), trauma (8 %), torsion (4 %) and tumour (2 %). No abnormality was seen on USG in 7 patients ( 14 %). This study concludes that USG is a sensitive and specific examination in patients with scrotal pain. Besides differentiating testicular from extratesticular origin it can also differentiate solid from cystic masses. Colour flow imaging is especially helpful in varicocele and testicular torsion. Torsion of the testis remains the most urgent and important entity dependent on USG for diagnosis. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 18-22 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6821


2016 ◽  
Vol 42 (5) ◽  
pp. 1028-1032 ◽  
Author(s):  
José Tadeu Nunes Tamanini ◽  
Vagner Tadeu Salzani ◽  
Juliana Milhomem Tamanini ◽  
Filipe Iessenco ◽  
Leonardo O. Reis

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