Torsion of testis hydatides or what is the danger of the disease?
Torsion of the testis is a pathological condition that is characterized by the rotation of the testicle around its axis in a vertical or horizontal plane. The main danger of this process is the compression of blood vessels and nerves, which are directly suitable for the reproductive organ of men. If in time (mainly up to 12 hours) an adequate treatment is not carried out, the result is necrosis of the parenchyma and the testicle dies. The disease is entered in the ICD 10 registry under a separate code.
It is important to note that this pathology is mainly of a nature for young children (1-3 years) and for adolescents (10-16 years). Nevertheless, cases were recorded when testicular torsion was recorded in elderly men 65-75 years old.
Factors that potentially increase the chance of developing a problem include:
- Inadequate testicular mobility. This can be triggered by impaired intrauterine development with the formation of an inferior Gunter ligament. Normally, she firmly fixes the testicle to the bottom of the scrotum and prevents its excessive movement. Abnormal growth of the vaginal process of the peritoneum is sometimes noted. In this case, the testicle becomes too mobile and moves like a tongue in a bell.
- The contraction of the muscle apparatus, which is responsible for pulling the testicle to the pelvis (m. Cremaster).
The most common causes of the development of pathology:
- severe coughing,
- sharp contractions of the abdominal muscles,
- too active sexual intercourse. Often there were episodes of looping testicles in men who practiced extreme ways of making love.
Sometimes there are situations when testicular torsion occurs during sleep. Most often, this is characteristic of children at an early age, when the muscles have not yet fully developed and there is not enough fixation of the organ in the scrotum. Timely treatment in the form of preventive hemming of the testicle to the bottom of the scrotum can prevent the development of the disease.
About 60% of all cases fall into 10-16 year old boys. Basically, the testicle rotates around a vertical axis by 180-360 degrees. Separately, they speak of an incomplete torsion, the consequence of which is a partial turnover of the organ without significant compression of the vessels and nerves. However, a group of men or children with a similar manifestation is at risk and should be constantly monitored by a surgeon.
According to ICD 10, the full testicular torsion is assigned the code N44. This is how patients' medical records are encrypted after discharge from the surgical hospital. Depending on the morphological changes in the organ, the following types of testicle rotation are distinguished:
- Extravaginal. It is characterized by a change in the position of the organ relative to its axis at a point above the attachment of the parietal sheet of the peritoneum. It is observed mainly in young children (up to 1 year).
- Intravaginal. Everything happens as well, but only below the attachment point.
- Torsion of the testicle on the mesentery. A relatively rare pathology, which is possible only with a serious separation of the mesentery from the appendage of the testicle itself. In this case, only vessels that pass inside the mesentery are squeezed.
Separately, it is worth highlighting the so-called torsion of testis hydatides. It is a rotation around its axis exclusively of the appendage without drawing the organ itself into the pathological process. It proceeds easier than the underlying disease and is often diagnosed directly during surgery.
Torsion of the testis - rotation, twisting of the spermatic cord around a vertical axis, accompanied by ischemia, and in severe cases, by testicular necrosis. The spermatic cord is an anatomical formation, which includes the vas deferens, testicular arteries and veins, lymphatic vessels and nerves, surrounded by the membranes of the spermatic cord. When the testicle is twisted, a sudden sharp violation of the blood supply to the testicle develops, which in a few hours can lead to irreversible damage and even death. These circumstances make it possible to attribute testicular torsion to the category of emergency conditions encountered in clinical urology and andrology. Testicular torsion occurs in 1 out of 4,000 men or in every 500th urological patient. Most often, pathology develops in children of adolescents aged 10-16 years, however, it can also occur in newborn children and adult men.
Etiology and pathogenesis
Among the main factors that can cause the development of testicular torsion, the following are noted:
- Pathological testicular motility. Underdevelopment of the Gunter ligament (which normally fixes the testicle to the bottom of the scrotum) or various intrauterine disorders of the formation of the vaginal process of the peritoneum can lead to it: the development of mesorchia (the mesentery of the testicle, which normally fixes it to the walls of the scrotum) is impaired, and the testicle acquires additional mobility by type of "bell language".
- Sharp contractions of the scrotum and muscle that lifts the testicle (which is possible with injuries, sudden movements, sudden tension of the abdominal muscles, masturbation, stubborn cough). However, the testicle can often be twisted in a dream. One of the predisposing factors for the development of testicular torsion is also wearing tight clothing.
Most often, this pathology occurs in early childhood and puberty, about 65% of cases occur in the age of 12-18 years. The frequency of occurrence in males under the age of 25 years varies from 1 in 4000 to 1 in 25 000. However, occasionally testicular torsion can be observed in a more mature age, including in the age period of 60-70 years. There is evidence that testicular torsion can occur before birth (in the prenatal period of development), which can lead to the birth of a boy with monarchism (the absence of one testicle).
All things being equal, a larger testicle (its large size may be caused by individual characteristics or a developing tumor) is more prone to torsion. The testicle is more often twisted along its vertical axis from the outside to the inside. The severity of torsion is different (usually about 80-180 or 180-360 degrees), however, cases of testicular torsion are also described at 1080 degrees.
In some cases, the so-called habitual testicular torsion (or partial torsion ), in which short-term symptoms of torsion spontaneously disappear. Patients with a similar pathology belong to the high-risk group for the development of complete torsion and, as a rule, they are shown surgical treatment (bilateral orchipexia), which almost always leads to the complete disappearance of all symptoms.
The following three types of testicular torsion are distinguished:
- Extravaginal form (extravaginal torsion), in which the testicle is twisted together with its vaginal membrane above the attachment of the parietal leaf of the vaginal membrane. This form is more common in children under the age of one year or in prenatal development, which leads to congenital testicular necrosis, requiring surgical removal.
- Intravaginal formin which the testicle is twisted inside the part of the spermatic cord that is in the cavity of the vaginal membrane of the testicle, the supravaginal part of the spermatic cord is not changed.It is more common at the age of 10-16 years, which is associated with a rapid increase in the size of the testicle at this age.
- Torsion of the testicle on the mesentery of the appendagein which the epididymis is not changed, and only those vessels that pass to the testicle along the mesentery of the appendage are transmitted. This option is possible only with a pronounced separation of the testis and appendage.
With any form of torsion, blood circulation in the testicle and its appendage is sharply disturbed, ischemic changes are observed in the gland, the severity of which strongly depends on the duration and degree of torsion, as well as on the length of the spermatic cord (with a shorter cord, the degree of destructive changes in the testicle will be greater) . In most cases, if untreated, six to eight hours after the development of torsion, irreversible necrotic changes develop in the testicle (sometimes a short-term torsion can lead only to testicular atrophy).
Probable complications of testicular torsion include:
The problem of men is that the vessels and nerve endings that feed the testicle are pinched. In the absence of adequate treatment, ischemia develops, then necrosis of the organ with its complete death. Ultimately, reproductive function may be completely lost.
Most often, a testicular turn occurs in the following way:
- Abbreviation m. cremaster leads to pulling the organ to the pelvis.
- In the presence of pathological mobility, it is arbitrarily twisted.
- The degree of rotation depends on the strength of the initial influence.
- Injuries and too active masturbation increase the risk of pathology. Nevertheless, the disease can develop in relatively calm circumstances.
- After pulling up and twisting voluntarily, the testicle rotates from the outside to the inside (70% of all cases).
- Further, the muscles relax, but due to the force of gravity and the finished turn, the testicle does not return to its original position.
- The vessels and nerves are constricted. Ischemia comes.
Cases are described when testicular torsion was observed at 1080 degrees.
What is a partial (repeated) torsion of the genital gland
In some men, a repeated (habitual, partial) testicular torsion is noted, a condition in which the sex gland independently returns to its natural position with the disappearance of complaints.
Patients who have repeatedly developed this pathological condition are at risk for the development of total torsion, and it would be appropriate to raise the question of possible surgical treatment (bilateral orchipexia), fixation of the mobile sex glands to the scrotum. This preventive measure allows you to permanently forget about unpleasant symptoms, significantly reduces the risk of orchiectomy, allows a man to play sports and lead a familiar lifestyle.
Testicular torsion is understood as the twisting of the spermatic cord, leading to its infringement and impaired testicular blood supply.
Torsion of the spermatic cord is manifested by clinically sudden severe pain in the scrotum, nausea, vomiting, collapse. The local symptoms of the disease include redness or blanching of the skin of the scrotum, unilateral swelling.
In the first hours after the testicle is twisted, a conservative treatment is possible, the essence of which is the manual external unwinding of the testicle. In all other cases, immediate surgical intervention is necessary. If the pathological process has gone too far and testicular necrosis has developed, then surgical removal is performed.
The most pronounced symptom of testicular torsion is sudden and sharp pain (both in the scrotum, and in the groin and lower abdomen). Often (especially in young children), nausea and vomiting are observed. Testicular testicular torsion is more often located above its usual position. Locally, redness of the skin and an increase in its temperature can be observed.Local symptoms can often be scanty, while general symptoms (abdominal pain, vomiting, fever, dyspeptic disorders) prevail. Sometimes an additional manifestation of testicular torsion may be acute urinary retention. The testicle itself usually increases in size, with palpation, its compacted consistency and soreness is determined.
In the absence of timely treatment after 18-24 hours, the pain often subsides, but local (edema, hyperemia) and general symptoms (fever, intoxication, usually noticeable only in children) continue to increase. In some cases (especially in infants), a collaptoid state may develop.
Torsion of the testis: what causes the pathology?
Often with manifestations of acute pain in the scrotum, testicular torsion is diagnosed. What causes this pathology? Inversion or torsion of the testis is a serious problem that threatens atrophy of the testicle. This condition occurs both in adult men and in boys of preschool, adolescence and youth.
Before characterizing the causes of this diagnosis, you should understand what exactly this disease implies.
Torsion of the testicle is the folding into a tourniquet of the spermatic cord, on which the testis body rests. Due to the violation of the anatomical attachment of the testicle in the scrotum, the testicle rotates around its axis.
In a state where the testis can rotate in any direction, the torsion of the spermatic cord can self-resolve. But in most cases this does not happen - there is an infringement of the blood vessels and nerves of the spermatic cord, which leads to the death of testis tissues.
First aid is very important for the manifestations of such a pathology. Only surgically can the testicular torsion be eliminated, which subsequently does not affect the reproductive function of the man.
This process relates to acute surgical pathology and requires immediate surgical intervention. If a child or an adult male has ischemia of the internal genital organ, then it is necessary to carry out surgical treatment as soon as possible.
Symptoms of testicular torsion include:
- Acute and sudden pain in the scrotum. She gives in the groin, lower abdomen.
- Young children often experience nausea and vomiting.
- A pathologically altered testicle is higher than a healthy testicle in the scrotum.
- An increase in the size of the damaged testicle.
- Local temperature increase.
- The skin may turn purple-red.
Torsion of the testis is a very dangerous problem. The described manifestations must necessarily alert adult patients or parents of children. You need to call an ambulance. Any delay may cause future reproductive failure.
Etiology of the pathological process (causes)
The disease is not congenital and most often progresses against such pathogenic factors as:
- severe bruising of the scrotum with its further swelling,
- sudden movements not previously characteristic of the body,
- increased abdominal tension,
- abnormal attachment of the testicle to the bottom of the scrotum,
- complication of cryptorchidism.
Once the cause of the disease is determined, it is possible to proceed to treatment, but its specificity (conservative or surgical method) determines the nature of the pathology and the characteristics of the patient's body.
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Symptoms of testicular torsion
To determine the symptoms of testicular torsion in a child or adult, you should know the time during which the pathology develops. The best diagnostic method is ultrasound, which shows the position of the testicles and spermatic cord.However, you can determine the disease if there are the following symptoms:
- sharp and sudden pains in the scrotum,
- discomfort radiating to the groin area,
- testicular hyperthermia,
- nausea, vomiting,
- local swelling of the scrotum in the area of the patient testicle,
- violation of urination
- difficulties with movement.
If the newborn has testicular torsion, the symptoms are accompanied by constant crying, whims. Redness is noticeable in the lesion, pain until it is impossible to touch. The first symptoms of testicular torsion in a child: the scrotum sometimes turns blue, there is a hydrocele from the torsion. A little boy loses his appetite, the testicle is slightly raised and noticeably convex, compared with a healthy organ.
Important! Immediate specialized treatment is required, if you do not provide assistance within the next day, the patient runs the risk of permanently losing the testicle.
Most often, differential diagnosis of testicular torsion should be carried out with orchitis (for testicular torsion, a sharper onset is characteristic) and epididymitis (the differential sign is that when the scrotum is raised, the pain with epididymitis often decreases, and with torsion, it usually does not change or even intensifies, with torsion the testicle more often than in inflammatory processes, the cremaster reflex weakens or disappears altogether), testicular trauma, torsion of the Morgagni hydatide (see below), less often with a restrained inguinal hernia, dropsy PFA, angioedema.
Laboratory tests of blood and urine in most cases do not allow confidently confirm the diagnosis of torsion or exclude diseases with similar symptoms. The most indicative method of instrumental diagnosis for suspected torsion of the testis is a Doppler ultrasound, which allows to detect circulatory disorders in the testicle. An even more indicative (but also much less accessible) method is dynamic testicular scintigraphy using technetium acid preparations enriched in 99m Tc isotope (for example, 99m Tc sodium pertechnetate). In some cases, endoscopic diagnostic methods can also be used.
In doubtful and urgent cases, as well as inaccessibility or inconclusive results of the use of instrumental methods, a diagnostic operation may be used, consisting in the dissection of the scrotum and lower part of the inguinal canal with the revision of the testicle.
In addition, after torsion of the testicle, atrophy of the organ may occur, infertility that cannot be treated, pathology leads to the formation of malignant tumors in the scrotum. Dangerous consequences - impaired blood, lymph exchange in which the appendage, testicle suffers. And this leads to adverse effects on the functionality of the genitals in general.
Advice! In order not to encounter a problem, avoid injuries of the external genitalia, wear comfortable underwear and use protective elements if necessary (in sports games).
Testicular torsion: symptoms
Twisting of spermatic cords in infants is very common due to the fact that in infants due to immaturity of the genital organs there is a greater mobility of testicles. Careless swaddling, crushing of the testicles and even an uncomfortable position can provoke a testicular torsion. Pathology can make itself felt before the birth of the boy, and during the birth of a woman.
In infants, torsion of the testicles is characterized by such signs as:
- vomiting reflex,
- anxiety, moodiness,
- scrotum enlargement,
- redness or blueness of the skin of the scrotal sac.
In the early stages of testicular torsion, a conservative treatment is possible, consisting in bloodless (closed) children (spread, untwisting) testicles.The testicle is grabbed with your fingers through the skin of the scrotum and, trying to leave the scrotum wall motionless, turn it towards the outside (towards the thigh), while slightly pulling the testicle down, repeating this manipulation several times. With successful detorsion, the pain syndrome disappears or significantly decreases, and the testicle itself somewhat drops down to the bottom of the scrotum. Even with successful closed detorsion, the patient is shown an urgent operation to fix the testicle in order to prevent relapse (successfully performed before the operation, detorsion in this case improves the results of surgical treatment). The exact frequency of successful bloodless detrusions is unknown due to the relative rarity of the pathology (however, it is most likely not too high: according to some estimates, only about 3%). If it is impossible to perform an emergency operation after closed detorsion for one reason or another, the use of drugs that improve microcirculation (trental, aminophylline, etc.), as well as the implementation of procaine blockade of the spermatic cord, are indicated.
In case of failed closed detorsion (as well as in the relatively late stages of testicular torsion), the patient is shown an emergency operation: after access to the testicle (in newborns and infants, inguinal access is more often used, in older children and adults, an incision is made on the front surface of the scrotum) and unwinding (detorsion), after which the testicle is fixed to the bottom and septum of the scrotum. In cases where the state of the testicle is doubtful, the testicle is heated with a warm isotonic solution for 20-25 minutes, papaverine-novocaine mixture with heparin is introduced into the spermatic cord. With obvious signs of testicular necrosis, an orchiectomy is performed.
An exceptionally conservative treatment of testicular torsion is fraught with the appearance of sperm antibodies in the patient's body (due to violation of the hematotesticular barrier), damage to the second testicle and infertility. In order to reduce the likelihood of such complications, all patients in the postoperative period are prescribed aspirin and heparin, in some cases corticosteroids.
Prevention of the disease is often impossible, since not all patients are aware of its existence.
It can be detected only at the appointment with a urologist, but this doctor can also confuse the torsion of hydatides with the epididymis with insufficient experience or carelessness.
But the prevention of the disease is worth doing, as this will avoid serious health problems.
Scrotum injuries often lead to this condition, so they should be avoided. It is also undesirable to cool the testicles very much and not to bathe in too cold water.
What it is?
During intrauterine development, numerous organs and organoids are formed in the fetus. They are necessary for the full work of all internal systems, but some formations lose their functions as the embryo develops. For example, at the site of the paramesonephral duct, after its natural sclerosis, a hydatide is formed.
Hydatide is called a racemose element in the form of a round or elongated outgrowth on a thin leg, which is located on the epididymis or in the area of their connection. In a normal state, the rudiment does not affect the functions of the male reproductive system. Many men do not suspect the presence of this formation until signs of pathology appear.
Twisting the leg of the hydatide around its axis causes a violation of local blood supply and is accompanied by acute pain in the scrotum.
Prognosis and prevention of testicular torsion
Only in 2-3% of patients, testicular torsion can be eliminated conservatively, in other cases surgical intervention is inevitable. If less than 6 hours have passed since the testicular torsion, the probability of organ viability is 90-100%, after 12-24 hours - 50-20%.There is evidence that in men who have previously undergone torsion of the spermatic cord, testicular cancer develops more often in the future.
Prevention of testicular torsion allows the prevention of scrotal organ injuries, the use of protection during sports activities, wearing loose clothing. Patients who have undergone testicular torsion are routinely recommended to perform preventive orchipexy from the opposite side, which helps prevent collateral testicular torsion in the future. If pain and swelling appear in the scrotum, you should immediately consult a doctor to exclude torsion of the testicle.
Testicular hydatide torsion: when the male appendix is on strike
A small process - testicular hydatide, located at the top of the testis in men, is considered an absolutely useless rudiment, the same as the tailbone or wisdom teeth. However, in the event of a pathology - torsion or bending - it brings a lot of trouble.
In case of untimely access to a doctor, the process goes into acute form, leading to hydatide necrosis. In this case, the patient is waiting for the removal of the scrotum.
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Why does the hydatide torsion occur?
Testid hydatide, being in a normal physiological state, does not cause a man any inconvenience - many do not even know about the existence of this organ. The cause of torsion of hydatida can be trauma to the scrotum.
Also, the development of the disease is possible with strong contractions of the muscles associated with the testicle.
This condition can cause physical overload when lifting weights or sex, banal hypothermia, a bright emotional outburst.
Pathology is more common in children during the maturation of the connective tissues of the scrotum. This is due to the imperfection of the nervous regulation of muscles in children, as well as the fact that the connective tissue in babies contains more fluid than in adults.
As a result of torsion or bending, the organ is not supplied with blood, the tissues are rotten (the testicles melt into pus) and gradually die. But even if the body somehow managed at one of the stages, infertility to the patient is almost guaranteed.
Symptoms of torsion hydatida
At the onset of the disease, the patient feels severe pain in the left or right side of the scrotum, it swells strongly and turns red. Then the edema subsides, and in its place becomes visible hydatide (the second name is the testicle appendix). This small formation (approximately with a bean) is bright crimson, closer to black or blue. Touching this place causes severe pain.
In adults, these are sometimes the only symptoms, in children and adolescents the body reacts more strongly - fever may rise, vomiting may begin.
The disease is easily diagnosed even in the early stages by the method of diaphanoscopy - the doctor reveals the scrotum with a special flashlight. Further diagnostics can go in two directions:
- HeldUltrasound scrotumdue to which the urologist accurately determines the size of the formation and its position, and also establishes the location of the proposed incision for the operation.
- Urologistopens the scrotum and immediately examines and removes the pathology.
How the diagnosis will be carried out depends on the condition in which the patient entered and other indications - the choice of method is exclusively in the doctor’s competence.
Is it necessary to treat testicular appendix and what will happen if not treated?
If untreated, the twisting and bending of the hydatide, a severe inflammation develops in the scrotum, which immediately spreads to the surrounding tissue. As a result, the patient expects complications:
- Dropsy testicle - the lymphatic structures of the scrotum are affected, which can lead to complete atrophy of the testicle,
- Epididymitis - this inflammatory process, flowing into a chronic form, leads to infertility,
- Testicular atrophy - violation of all functions of the testis, tissue necrosis, purulent fusion of the structures of the scrotum.
Due to the high likelihood of developing these complications, torsion of hydatides requires an immediate visit to a urologist and surgery.
Three myths about the treatment of hydatid torsion
Myth number 1. The hydatid leg will set itself
Twisting and bending the hydatid legs does not pass on its own.
If the pathology is not eliminated, severe inflammation is guaranteed, which easily spreads to surrounding tissues. Because of the danger of complications during torsion, hydatides urgently perform an operation.
Myth number 2. You can cure testicular hydatide torsion with medications
Stories about the treatment with drugs and manual reduction of hydatides are fairy tales. But drink pills - anti-inflammatory and painkillers - still have to. This will help avoid postoperative pain and complications.
It is impossible to correct the position of the hydatide using a manual method. Moreover, carrying out such manipulations is dangerous. When pressed, the abscess will burst and the infection will spread throughout the scrotum.
Myth number 3. It is difficult and dangerous to remove hydatide
Operation on the testicle is carried out urgently in the clinic without special preparation. The urologist carefully dissects the testicular tissue and removes the twisted hydatide. Local anesthesia is sufficient for the procedure. If everything is done under sterile conditions, there is nothing dangerous in the operation.
The consequences of pathology
To prevent serious complications, issues of timely diagnosis, prevention and adequate treatment of pathologies of the scrotum are of great importance. In approximately 40-80% of male patients who have been diagnosed with acute pathologies, including testicular torsion, atrophy in spermatogenic epithelium is detected. Due to this pathology, infertility develops. If conservative therapy was chosen, then probable testicular atrophy. Untimely surgical intervention can lead to the removal of the appendage.
For diagnosis, the patient undergoes a thorough examination with palpation, in addition, you need to collect an anamnesis. After that, hardware diagnostic techniques will be needed:
- Ultrasound research is the main diagnostic method with which you can determine not only the degree of torsion, but also the state of the organ itself.
- Dopplerography, due to which the vascular network is examined.
- Using a radionuclide study, the vascular flow is studied, thanks to which the testicle feeds.
- Diaphanoscopy, which consists in scanning the scrotum.
And laboratory tests are also prescribed, which can make it possible to identify inflammation in the body or the pathogen. A general analysis of blood, urine, blood for biochemical parameters is given. If there is effusion, a diagnostic puncture will be required. In some cases, rectal examinations are prescribed to the patient.
With any form of pathology, the testicle is exposed to the shell. So it becomes possible to carry out a wide resection. Next, the specialist determines the form of inversion. The testicle is peeling in the wound. Then the doctor performs a detorsion and assesses the viability of the organ. To improve microcirculation and determine the preservation of the element, the introduction of 10-20 milliliters of a 0.25-0.5% novocaine (procaine) solution with sodium heparin into the spermatic cord region is recommended. If there is no improvement in blood circulation after 15 minutes, the patient is shown an orchiectomy. You can also use heat compresses with a solution of sodium chloride (isotonic). They are put on for 20-30 minutes. When blood circulation is restored, the testicle acquires its natural color.
Recovery of the patient after surgery lasts 2-6 weeks (depending on the complexity of the operation, the severity of the pathological process and the dynamics of recovery). At this time, the use of sensitizing agents, drugs to restore blood microcirculation, acetylsalicylic acid is indicated.
If the restoration is normal, then the seams are removed after seven days. After this, the patient may be prescribed physiotherapeutic procedures (galvanization, UHF, magnetotherapy). The duration of these procedures should not exceed 20 minutes, since prolonged exposure to high temperatures leads to disruption of sperm production.
Antiseptic dressings are applied to prevent suture. Stopping the testicular torsion is a rather traumatic operation, therefore, during the rehabilitation period, the scrotum is fixed with caution. Adolescents and youths are advised to wear a retaining brace.
Many men worry that after surgery, they may develop infertility. In fact, in most cases this does not happen even after removal of one testicle, since the remaining testicle completely copes with its responsibilities for the synthesis of sperm.
The bend of the hydatide disrupts the blood supply to the organ, because of this, the tissues are gradually exposed to necrotic lesions. Against the background of the inflammatory process, pus is formed in the testicle, which melts the internal structures of the testicles. Inflammation rapidly progresses and spreads to surrounding tissues, so torsion often leads to complications. The disease causes:
- dropsy of the testicle - damage to the lymphatic structures, up to complete organ atrophy (we recommend reading: dropsy in children: symptoms and treatment with a photo),
- epididymitis is a chronic inflammation that often leads to male infertility.
Usually, necrosis develops when parents do not pay attention to the manifestations of the problem in children and delay the visit to the doctor. The later the disease is detected, the higher the risk of irreversible changes. Sometimes a triggered torsion of hydatids causes removal of the scrotum.
Testicular torsion, consequences
The consequences of torsion depend on how quickly after the onset of the first symptoms the patient seeks medical help. The later the surgery will be performed, the less likely it is to save the testicle.
If a person consulted a doctor within six hours after the onset of pain, the probability of preserving the testicle and complete recovery is 90-100%. If the patient goes to the doctors during the day, then the probability of preserving the testis is 50-75%.
If the patient asked for help in a day or more, then the probability of preserving the testicle does not exceed 10%, since in this case necrosis almost always develops and the organ dies.
One of the most frequent and unpleasant consequences of torsion is the development of male infertility. The disease develops as a result of impaired sperm production, which is associated with partial or complete loss of testicular tissue.
In addition, torsion can trigger the development of testicular cancer. With untimely seeking medical help, the following complications can also develop:
- testicular necrosis followed by death
- purulent inflammation,
- testicular rupture.
You can prevent this development of events if you consult a doctor immediately after the appearance of the first unpleasant symptoms.
Symptoms in adults
In adult men, the main sign of torsion is a sharp pain in the testicle, which sometimes extends to the groin and lower abdomen. Redness of the testicles is also noted. Men complain of urinary retention, fever up to 38 degrees and dyspeptic disorders. At the initial stage, torsion is often accompanied by vomiting and the so-called collaptoid state.
With the independent return of the testis to its place, often the pain suddenly stops. Below we list the local signs of the disease:
- scrotum asymmetry due to severe swelling
- redness of the affected area,
- the testicle is enlarged,
- the spermatic cord is thickened, painful sensations occur when touched
- poorly expressed cremasteric reflex.
Torsion of the testis in children of preschool and primary school age: symptoms
Children aged three to ten years are not immune from the development of testicular torsion. Most contributing to this:
- injuries due to non-observance of safety precautions when riding a bicycle, playing sports,
- excessive exercise
- hyperactivity in children.
Children's negligence can lead to irreversible consequences - infertility. Symptoms of testicular torsion in preteen adolescence boils down to the following:
- tingling in one of the testicles
- visible asymmetry of the testes,
- sharp sharp pain that occurs suddenly
- scrotum pain in groin
- high body temperature and nausea.
In adult men, testicular torsion: symptoms. The testicle of an adult male in terms of anatomical structure is no different from the testis. The difference is only in the size of the testicles. Torsion of the testis can provoke excessive physical exertion or a violation of the structure of the testes.
In an adult male, pathology is accompanied by:
- sudden inguinal pains
- high blood pressure
- nausea and dizziness
- irregular body temperature,
- physical fatigue
- increased sensitivity and enlargement of the scrotum, as well as a change in the color of her skin.
Removing the testicle is a rather complicated operation. That is why, after its implementation, it is necessary to provide the patient with the correct rehabilitation period. Surgical intervention is negatively displayed not only physiologically, but also psychologically. Rehabilitation is rather difficult in adolescence, which is explained by the emergence of a sense of inferiority among one-year-olds. In order to eliminate the discomfort after surgery, in most cases silicone prostheses are used. They are characterized by the presence of three sizes, which allows you to choose the most optimal option in a particular case.
Thanks to the improvement of technical evolution in the field of prosthetics, implants cannot be distinguished by touch from a real testicle. If the sexual partner has not been told about surgical intervention, then he will never know about it. If a man has one normally functioning testicle, he will be able to avoid infertility.
At the moment, a special diet is not applied after the operation. That is why during the rehabilitation period it is recommended to adhere to the 15th table according to Pevzner. This diet is balanced and high-calorie, which is positively displayed on the well-being of the patient. In terms of sex, patients need to slightly change their lifestyle. If the surgery was performed on a child, then in this aspect there will be no problems.
Adolescents and adults of the stronger sex need to refrain from sexual relations for a month. If it becomes necessary to conduct another implant implantation operation, it is recommended to limit sexual activity for a period of three months. In the postoperative period, patients are prescribed sensitizing drugs or physiotherapy.
Compliance with the rules of the postoperative period will ensure the successful treatment of torsion. That is why patients are advised to behave in accordance with the recommendations of the doctor.
It is impossible to independently treat this ailment! If the scrotum is injured and the child is very small, call an ambulance. Or take the child to the doctor yourself without delay. The method of treatment will depend on how soon you seek help.
If an injury occurred less than 6 hours ago, then the organ can be saved with a 100% probability - that is why the timely and accurate reaction of parents to the condition of the baby is so important.
If more than six hours have passed since the injury, it is difficult to make predictions. And if a day has passed, then saving the testicle is not possible - it will already be unviable.
The pathology can be cured only by unwinding the spermatic cord:
- Conservative method - the doctor manually unwinds the cord in the opposite direction, this is done in a few minutes, if there is no result, then other actions are needed.
- Surgical method - the child is given general anesthesia, the doctor exposes the testicle from the protein coat, and during the operation itself it is concluded whether the testicle is viable, it must be removed or attached to the appendages.
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Access to operational measures involves several options.
If we are talking about babies, then it will be inguinal surgery, in children older than 10 years and in adult men access is usually chosen through the scrotum.
The testicle is removed if complete necrosis is detected. But if the testicle is preserved, then it is sutured to the scrotal septum with two or three stitches for the lower ligament of the appendage. Then a drainage tube is inserted into the wound, and irrigation with antibiotics is established.
General pathology information
This pathology is accompanied by twisting of the spermatic cord around its vertical axis. As you know, the vas deferens, nerves, lymphatic vessels, as well as arteries and veins, which provide testicular tissue with oxygen and nutrients, pass through the spermatic cord.
When torsion, the lumen of the blood vessels narrows, which leads to a violation of trophic tissue. Testicles do not receive a sufficient amount of energy substrates and are deprived of the ability to excrete cell waste products. That is why torsion is so dangerous - in a matter of hours, pathology can lead to necrosis.
According to statistics, the problem is recorded in a ratio of 1: 4000. In most cases, pathology is diagnosed in adolescents aged 10 to 16 years. Nevertheless, torsion is not excluded in infants, as well as in patients of mature age.
Diagnosis of this condition is rarely fraught with difficulties. During the examination, the doctor may notice swelling of the scrotum. Palpation is accompanied by sharp pain. The testicle loses its natural mobility. In addition, a specialist can feel for a short but thick spermatic cord. Of course, further studies are carried out in the future, since some other diseases are accompanied by approximately the same symptoms (for example, inflammation of the testicle or appendage).
An ultrasound of the scrotum organs is mandatory. Assessing the echogenicity of various structures, the doctor can determine the presence of necrosis and the degree of its spread. In addition, an ultrasound examination of the vessels of the scrotum is performed, which allows to determine the quality of blood supply to the organs of the scrotum. To examine the testicles, a diaphanoscopy is performed - with the help of a special device, the doctor “shines through” the scrotum, determines the density of organs.
Sometimes an additional puncture of the testicles is performed. This procedure allows you to determine the composition of the contents of the membranes (for example, whether there is blood in the liquid, notes of pus, etc.).
During the development of the anomaly, the testicle rotates vertically around its axis. The testicle, which rotates more than 180 ° together with the cord, disrupts blood circulation in it and as a result there are many hemorrhages, venous thrombosis in the cord or serous-hemorrhagic transudate at the bottom of the testicle, where the skin swells.
The non-vaginal inversion of the testicle occurs due to the immaturity of the cord and its soft tissues - muscle contraction leads to poor attachment to each other.
Intravaginal inversion of the testicle occurs in the vagina. Most often found in children from 3 years of age and older, especially during adolescence 10-16 years. How does this happen?
Initially, the muscles contract, thereby causing the testicle to rise, it, together with the surrounding soft tissues, rises and performs twisting. The dense fusion of the membranes and the inguinal canal, which encompasses the cord like a tube, does not allow the testicle to make a full torsion around the axis and as a result the rotation stops.
The testicle has a mesentery, and therefore has excessive activity in the vaginal process of the peritoneum itself, continuing its rotation. After that, the muscle fibers weaken. The raised testicle into the cavity of the scrotum, remains there due to the bulges, and remains to lie horizontally. If the muscles continue to contract and help lift the testicle, the looping does not stop.
With an increase in non-vaginal and intravaginal seizures, testicular inversion during puberty or prepubertal period indicates a disproportionate increase in testicular weight in adolescence. This suggests that the process of testicular inversion, together with various factors, undoubtedly affect the growth of the reproductive apparatus.
Causes of testicular inversion may be cryptorchidism, in children - prematurity. Excessive physical exertion and underwear or clothing closely adjacent to the body are also affected.
Forecast and consequences
If the problem is solved in the next 6-8 hours, then you can save the testicle. With untimely intervention, tissue necrosis occurs and there is a high risk of developing the following complications:
- the formation of an abscess caused by the spread of infection,
- dysuria - a violation of the urination process, accompanied by false desires, a burning sensation and pain,
- hematuria - the appearance in the urine of blood secretions,
- hydrocele - a pathological accumulation of fluid in the inner shell of the testicle, causing discomfort, pain and a feeling of heaviness in the scrotum,
Men who have had the disease have an increased risk of developing testicular cancer.
What is testicular hydatide torsion
Many experts believe that the best way to treat this pathology is operative. Surgically, you can solve this pathological process in a short time, without the presence of any complications. The patient quickly recovers after surgery without any features. The operational method for hydatide is not complicated in its complexity and is carried out quickly.
Testicular hydatide surgery is performed in this way:
- An incision in the area of localization of the pathological process on the scrotum along the skin.
- Finding by palpation of the hydatide itself, which is the size of a bean.
- Hydatide fixation and complete clipping behind the base. Removal is carried out using a conventional scalpel.
- Squeezing the bean-shaped removal site.
- Stitching the incision site with ordinary sutures.
This is the operation to remove testicular hydatide. In order to prevent the development of various infectious and inflammatory processes in the field of postoperative wounds, the doctor prescribes antibiotic therapy. The most optimal drug for preventing complications is ceftriaxone. In its absence, ampicillin can be administered to the patient.
Also an important procedure is the conduct of antiseptic procedures. These are dressings with betadine or other antiseptics. Dressings are carried out on the basis of solutions of aqueous or alcoholic origin.
This surgical intervention is carried out only within the walls of a medical institution, in a hospital setting.With positive dynamics in the postoperative period, the patient can be released for outpatient treatment. It is necessary to completely control yourself and prevent the entry of various infectious agents.
To prevent problems and various complications, the patient should wear loose-fitting clothing in the groin area. For some time, do not take water procedures, do not wet the place of the operation. Exclude various intimate relationships with a sexual partner.
If testicular hydatide necrosis is observed, surgery is performed only to amputate the organ. Usually this happens when the patient has not consulted doctors for a long time, or was treated independently at home.
The testis hydatide in a boy is performed in the same manner as in adult men.
Treatment of such a disease can be carried out in a conservative way. But there is one thing, but. Such reduction is carried out only at the initial stages of the appearance of hydatide. Such a procedure is reproduced manually. If the effectiveness of such treatment is not observed, then only an operation is performed.
It is strictly forbidden to apply various compresses, and try to independently solve such a problem. Only an experienced specialist can help with this pathology.
Testicular hydatide is a rudimentary process that is located in the upper part of the testis. Also referred to as the appendix, but, to prevent confusion with the abdominal organ, is better known as the hydatide of Morgagni.
Torsion of the process is considered a rare pathology. Diagnosis of the condition is complicated by the similarity of the clinical picture of the deviation with the manifestations of acute epididymitis. An anomaly can cause a stoppage of blood supply in the testis, which provokes the development of organ gangrene. That is why, when the first signs of a violation appear, it is necessary to contact a medical institution as soon as possible.
Scientists have found that the violation of the circulatory hydatide is a consequence of its torsion. Suspension inversion occurs in the presence of a long or narrow leg. Such a deviation provokes a stop in the venous and arterial blood flow, leading to the development of hemorrhagic heart attack. Various microtraumas and inflammatory processes of the genitourinary system, which proceed in an acute form, contribute to the death of hydatide tissues.
Consequences after surgery
It is extremely rare that complications develop after improperly performed surgical intervention. The human factor is possible - erroneous ligation of the vas deferens, damage to the nerve of the genitals. Such consequences can cause potency disorders. In violation of the rules of asepsis, there is a possibility of postoperative infection. You can avoid unpleasant consequences if you turn to a trusted specialist in a good clinic.
Video: Torsion of the spermatic cord
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|Ultrasound urological expert||2 750 rub.|
|SCD sperm DNA fragmentation study||7 150 rub|
|TUNEL sperm DNA fragmentation study with gradient||8 000 rub.|
|TUNEL sperm DNA fragmentation study without gradient||8 800 rub.|
|Ultrasound urology with dopplerometry||3 300 rub.|
|Ultrasound urological expert||2 750 rub.|
Rehabilitation after surgery
Rehabilitation period more than important. Physiotherapy is mandatory for the child, the patient is given sensitizing drugs and drugs to normalize microcirculation in the testicle.
Sutures after surgery are removed after about a week.
Some hospitals practice therapy with galvanization, UHF, and magnetotherapy. Sensors of this equipment are attached to both sides of the scrotum of the child, the procedure lasts no more than 20 minutes, because high temperatures will not affect spermatogenesis processes in the best way.
It is very important to ensure that the child does not catch a cold after surgery. Even a small viral infection can seriously affect the rehabilitation process.
Patients are also not allowed be in the cold for a long time, swim in cold water, drink cold juices and compotes.
Of course, no one conducts such experiments with children, but the operation is done for boys of different ages, and adult men, too, because it is worth knowing.
Testicular torsion repair - testicular surgery
With reversible and irreversible twisting of the spermatic cord, surgery is inevitable. Torsion of the testis is often diagnosed on one of the two testes, so surgical intervention does not mean a complete loss of the possibility of conception of children. The remaining testicle takes on reproductive functions if there was a forced testicular operation.
The effectiveness of treatment of testicular torsion depends on whether the pathology is congenital or acquired, as well as on the development of concomitant diseases.
Torsion of the hydatides of Morgagni
A similar clinical picture, pathogenesis, and treatment principles are also observed in testicular and appendage hydatide torsions (the so-called hydatides of Morgagni are rudimentary processes, testicle and appendage pendants, which are the remnants of the paramesonephric duct). Torsion of Morgagni hydatides, as a rule, is characterized by a more erased and "mild" course of the disease and relatively less frequent complications (compared with torsion of the testicle). Diagnosis of this pathology is rather difficult, the final diagnosis is often made only intraoperatively.
Rehabilitation period: what rules should be followed?
Surgery for testicular torsion is considered relatively simple. Nevertheless, after the procedure, patients need to follow some recommendations - this will help speed up the healing process and minimize the likelihood of complications.
It is immediately worth noting that the recovery period lasts from 2 to 6 weeks. In the first few days, it is important to constantly change dressings, treat damaged tissues with antiseptic solutions, as well as decoctions of some medicinal herbs (sage, chamomile, oak bark relieve swelling and inflammation).
In the first few weeks, patients are advised to wear special bandage underwear, which keeps the scrotum organs in position and prevents the formation of edema. Men are sometimes sent to various physiotherapeutic procedures. In addition, it is necessary to abandon hot baths.
Gradually, patients return to their usual way of life. Nevertheless, in the first few months, you should refuse to visit baths and saunas. Hypothermia is also harmful - it is better to dress according to the weather.
Also, experts recommend avoiding heavy lifting and intense physical exertion - this can lead to relapse or torsion of another testicle. During the first 2-3 months, it is better to refuse sexual intercourse, as this also increases the likelihood of complications.
Of course, the patient is registered with a doctor and regularly undergoes scheduled medical examinations (even if some disturbing symptoms are completely absent).
What is a testicular torsion in a boy: diagnosis, consequences
About what constitutes torsion of a testicle in a boy, many parents will find out in the office of a urologist or surgeon. Often the symptoms of a dangerous condition are associated with inflammation, the consequences of domestic injuries and other health problems of the child. Few people know that not paying serious attention to a problem at any age can lead to irreparable consequences.
Surgery is the only way out for adult men, especially if a long period of time has passed after the twisting of the testicle happened. The procedure is as follows:
- the scrotum dissects to the shell of the egg,
- the doctor unwinds the spermatic cord, determining the viability of the tissues,
- to improve microcirculation and to preserve the testicle, a solution of novocaine with sodium heparin is injected into the spermatic cord.
If after a quarter of an hour there is no efficiency, the testicle does not take a normal shade, blood supply does not normalize, then an organ resection is performed.
Postoperative therapy is designed to cure the patient and restore the functionality of the testicle. Novocaine blockades, aspirin, heparin are used. If the symptom of high mobility is not eliminated, then an operation is assigned to consolidate - this will prevent the possibility of relapse.
Complications after surgery are possible only in cases of untimely assistance. The time interval of 100% absence of postoperative complications is 6-10 hours, but antibiotic prophylaxis is carried out. The consequences of lack of help are the same for both a child and an adult - it can be: inflammation of the scrotum, dropsy, rupture of the tubule, testicle and infertility.
Important! There is statistical evidence that the torsion of the testicle can indirectly provoke the development of oncology after many years. Therefore, pathology is considered extremely dangerous for patients of any age..
Rehabilitation after surgery
Rehabilitation techniques after removal of the testicle appendix include physiotherapeutic treatment: magnetotherapy and galvanization. The urologist can prescribe immunomodulating and anti-inflammatory drugs.
In the postoperative period, you can not lift weights, jump (seams will open), you need to protect yourself from colds and hypothermia of the lower body. For some time (before the doctor’s permission) one will have to refrain from taking baths.
Torsion of the testis in boys: features of symptoms
The following signs indicate the infringement of the blood vessels and nerves of the spermatic cord due to the rotation of the testis around its axis due to the lack of fixation in the child:
- soreness of the scrotum on one side when touched, when performing movements, in a standing position, sitting and lying down,
- swelling of the testis,
- a change in the shape of the scrotum, the formation of a bulge, tension on the one hand,
- a change in the color of the skin of the scrotum, either redness or blueness resembling a painful hematoma can be observed,
- an increase in body temperature against the background of the manifestation of pain in the scrotum,
- lack of appetite,
- nausea and vomiting,
- physical weakness.
On physical examination, testicular torsion (photo 1) is manifested by deformation of the scrotum, elevated condition of one of the testes - one testicle is much higher than the other.
If a child complains of a sudden manifestation of pain in the testicle, which does not go away, but intensifies, this is 70% of cases of testicular torsion. Symptoms of children of different ages with this pathology of the ovaries are not much different.
It should be noted that in infancy there is practically no painful scrotal syndrome, indicating testicular torsion. Symptoms in a child with this problem are more associated with a violation of the digestive process, an increase in body temperature.
Ⅰ. Testicular torsion: consequences
Specialists in the field of urology and reproductology inform parents of minor boys that torsion of the testes is not a harmless injury, but a serious condition, the consequences of which are as follows:
- orchiectomy - the operable removal of one of two testicles,
- complete infertility of a man
- the development of cancer of the reproductive system.
Ⅱ. Types of testicular torsion
In medical practice, there are either left-side infringement of the spermatic cord of the testicle or right-sided.Bilateral pathology is not excluded, however, it is extremely rarely diagnosed. There are cases when the torsion of one testicle was the cause of the torsion of the second testis subsequently.
Ⅲ. Diagnosis of testicular torsion in children
To confirm the alleged diagnosis, an emergency diagnosis of the scrotum is assigned to the child who is admitted to the hospital, namely:
- palpation of the scrotum,
- genital ultrasound,
- scrotum puncture
- ultrasound dopplerography of the scrotum vessels.
How to fix a testicle after torsion?
The testis takes its initial position in the scrotum only:
- with manual adjustment, this method is applicable in the treatment of testicular torsion in infants and preschool children,
- with surgical intervention, without which it is almost impossible to eliminate the pathology in adolescents and youths.
To prevent atrophy of the testis is the main goal of the doctor in assisting the patient. If no more than six hours have passed after the onset of the first symptoms, the chances of saving the viability of the testicle are high, if more, the predictions are doubtful, although in practice, the specialists managed to restore testicular function operably after more than a day.
The prognosis of a child’s healing depends not only on the treatment method, but also on the severity of the reasons that provoked a painfully dangerous condition.
Ⅳ. How to protect a child from testicular torsion?
The pathological process of testicular rotation in the scrotum that occurs during the development of the boy can be prevented:
- limiting the child’s excessive activity,
- prevention of domestic injuries,
- instilling in the child the habit of wearing loose underwear.
The development of a congenital pathology depends on the genetic background of the parents and its development is almost impossible to predict.
The hydatide of the testis and its appendage is an additional formation, which is a cyst on the leg, due to which torsion occurs. This violation is most often found in boys 10-15 years old and is considered the vestigial of the Muller ducts.
The first mention of hydatides, called hydatides of Morgania, dates back to the 18th century. And in medical directories, this pathology is referred to as the appendix of the testis, appendage and other organs of the scrotum.
There are several reasons for the occurrence of hydatide torsion, but the most basic are:
- Circulatory disturbance, in particular venous outflow.
- Genital injuries.
- Excessive testicular mobility during physical exertion.
- Underdeveloped connective tissue (the most common cause of torsion in children).
- Inflammatory processes.
- Stressful situations.
Torsion of the testicles in men: features
A man may experience painful sensations in the scrotum throughout his life. There are many reasons that provoke pain in the scrotum, therefore, at the first manifestations of the symptoms of infringement of the spermatic cord of the testicle, few people rush to the doctor for a consultation and after a few hours appear on the operating table with a diagnosis of testicular torsion.
The international classification of MKD diseases characterizes testicular torsion in men as a pathology associated with excessive testicular mobility that occurs in the process of impaired attachment of the testicle to the walls of the scrotum.
How to recognize testicular torsion disease - ICD-10 - N44?
Torsion of testicles in men is manifested by a characteristic sudden pain syndrome. If you feel severe pain, a man cannot be calm in any position: sitting, standing, lying down. Pain can be so intolerable that a man can lose consciousness. Often, increasing attacks of pain are accompanied by:
- nausea and fever,
- jumps in blood pressure may also be observed.
Ⅰ. Consequences of twisting testicular spermatic cord
Torsion of the testicles requires immediate hospitalization of the man, examination and confirmation of the diagnosis of surgery. Infringement of the spermatic cord leads to testicular necrosis or atrophy, which is fraught with irreversible removal of the testicle.
Proven is the fact that testicular torsion can be a precursor of cancer of the scrotum.
Ⅱ. Methodology for eliminating pathology in men
Only surgical intervention contributes to the expansion of the spermatic cord and the correct fixation of the testicle in the scrotum cavity in men. The operation is appropriate and:
- with viability of the tissues of the testis,
- and with testicular atrophy due to untimely seeking help.
In the first case, the man retains his reproductive capacity, in the second - only with the full health of the remaining testicle, on which the functionality of the removed testis is transferred.
With testicular atrophy, surgery does not allow the development of sepsis, which threatens a man with a fatal outcome.
Forecasts of recovery after surgery on the testicles are optimistic.
Torsion of the testis: causes provoking the disease
The pathology of the testicles resulting from the excessive mobility of the testes, as characterized by torsion of the testicles of the ICD-10, may not occur from scratch. The factors provoking this condition are numerous. The main ones are:
- hereditary predisposition
- congenital pathology of the structure of the genital organs,
- morphological immaturity of spermatic cords and surrounding tissues, determined by muscle hypertonicity, friability of testis membranes, direct, wide or short inguinal canal,
- muscle cramps responsible for raising the testicles when exposed to cold, during intercourse, when the temperature rises in the cavities of the scrotum, with a sense of danger,
- adhesions in the scrotum cavity,
- household injuries of the scrotum,
- contraction of the abdominal muscles due to excessive physical exertion,
- active sex life
- frequent masturbation
- extreme types of sex,
- active physical activity.
It should be noted that inflammatory processes in the scrotum can be a factor provoking torsion of the testis. The reasons are sometimes inexplicable when making a diagnosis, so that no man is immune from painful infringement of the spermatic cord of the testicle. This problem can occur at any age.
Scrotum diaphanoscopy is the scrotal scans of a scrotum with a flashlight in order to detect a dark formation, which indicates the presence of torsion.
An ultrasound of the scrotum will show the location and size of the affected areas, looking like protrusions up to 5 mm in size. This will help in the operation.
It is important to differentiate torsion from other testicular pathologies, in particular from orchitis, which are similar in manifestations, but are treated differently.
Torsion of the left testicle: varieties
As many experts in the field of urology note, torsion of the left testis due to the anatomical structure of the scrotum is more common than the right. Cases of bilateral pathology are not excluded.
When assessing the condition of the patient, specialists identify:
- extravaginal infringement - the testis during rotation is localized above the parietal sheet of the peritoneum,
- intravaginal infringement - the testicle is below the attachment point of the parietal sheet of the peritoneum,
- infringement of the mesentery - compression of the vessels of the mesentery of the testicle, as a result of its separation from the body of the testis,
- infringement of hydatids - infringement of the epididymis.
Torsion of the testicle of the left: treatment
Torsion of the testis is successfully eliminated through surgical intervention, but the doctors do not give guarantees of the absence of a relapse of the disease after surgery.
If the torsion of the testis of the left and testicle of the right proceeds identically, then the treatment has some special differences.So, with manual rotation of the left testis, the infringement of the spermatic cord is eliminated by rotating the testicle counterclockwise, and the right - clockwise.
How to determine testicular torsion and features of surgical intervention when looping testicles
Operation with infringement of the male testicles, or rather the spermatic cord or appendages, is inevitable with a complete torsion, and with frequent manifestations of the symptoms of this pathology. Surgical intervention makes it possible to get to the place of infringement and fix the testes in the correct position, preventing their incorrect rotation on the vertical and horizontal axis subsequently.
Prevention of an operable treatment for testicular torsion consists only in preventing a dangerous condition for a man. The scrutiny of the organs of the scrotum allows each man to be attentive to the health of the reproductive organs. When it comes to children, their health depends on the care of the parents.
The success of an operable treatment for the diagnosis of ICD-10-No. 44 depends on how quickly the man or parents of the child react to the symptoms of a dangerous condition. Often the pain in the scrotum is taken for the consequences of bruises, sexual abstinence, and inflammation. But in the process of the development of these problems, the painful sensations are progressive, while they characterize the torsion of the testicle of the pain, sudden and sharp, which can occur both at the time of exercise and in a dream.
A little physiology
Hydatide is the rudimentary residue of the Muller ducts. It is a small formation on top of the testicle. Consists of separate lobules and a network of convoluted tubules. Cystic expansion stands on a thin leg.
It does not interfere with a full life, but in some cases a thin and long leg can twist around its axis. As a result, blood flow becomes difficult, and the formation becomes inflamed. The code for ICD 10 is No. 44.
Torsion of the testis (photo) in a child
In infants, testicular torsion is often found immediately after birth. Congenital pathology proceeds almost painlessly, letting the irregular shape of the scrotum and its cyanosis know about itself. Torsion of the testis (photo 1) in children is often accompanied by fever and vomiting.
The problem can be felt with tight swaddling, careless handling of the baby's genitals during hygiene procedures, with infrequent diaper changes. In any case, the turning blue of one of the two halves of the scrotal sac in an infant is an urgent reason to contact a pediatric urologist.
In children from two to ten years, testicular torsion is most often the result of injuries. Taking the soreness and cyanosis of the scrotum for a hematoma, parents often delay a visit to the doctor, which leads to an aggravation of the problem.
Why is she twisting
Most often, torsion is diagnosed in boys in childhood. In children older than 8 - 10 years, pathology is practically not found, since the tissue surrounding the testicles has already fully formed.
The main causes of torsion include the following:
- genital injuries of a severe nature,
- prolonged hypothermia - with a long stay in the cold, the testicles are compressed, which can lead to torsion,
- physical overload.
Also, the disease can be associated with abnormal development of connective tissue in the body or with pathological disorders of the innervation of scrotum tissue. These causes are congenital.
The testis hydatide in a boy with a thin and long stalk, as well as an inflamed formation, is most often prone to torsion.
Symptoms directly depend on the degree of the disease. Torsion of the testis in a child is manifested in the following signs:
- The patient develops intolerable pain localized in the scrotum.One of its sections swells: swelling of the left or right testicle is fixed.
- Swelling gradually subsides, but hyperemia or redness in the upper part of the scrotum remains. Even during a weak touch on the affected area, a person feels severe pain.
- If the victim did not consult a doctor and surgical care was not provided, then necrosis of other tissues of the genital organs develops. In severe cases, the patient begins intoxication of the body - nausea, fever, etc. In advanced situations, amputation of the entire scrotum is possible.
The condition of the genital organs with twisted hydatide can be seen in the photo above.
How to carry out rehabilitation
In addition to the course of antibiotics, it is necessary to regularly treat the wound, this will accelerate the postoperative period and avoid complications.
Daily ligation promotes rapid regeneration and helps to avoid secondary infection. Doctors treat the wound with an alcohol solution or iodine, then put on a sterile dressing. Sutures are removed a week after surgery.
Sometimes doctors prescribe the passage of physiotherapeutic procedures. These can be magnetotherapy, galvanization or UHF courses. Also, during the rehabilitation period, you should be careful about your health, you need to beware of viral diseases, as they complicate recovery.
During the operation, the hematotesticular barrier is partially violated. It protects the testes from infection. Therefore, you need to avoid hypothermia, do not sit on a cold surface, do not swim in cold and cool water.
If the surgery is carried out correctly, then the consequences after the operation are not diagnosed. Otherwise, orchitis, epididymitis and other infectious processes are possible.
If the baby or teenager has sutures on the scrotum, the fever lasts longer than three days after the operation, suppuration is noticeable, then it is worth telling the doctor about this.
Alternative therapy for looping is impossible, but there are a number of tips that help you recover faster after surgery.
After consulting with your doctor, you can use the following recipes that accelerate wound healing:
- Combine 200 milliliters of vegetable oil and 75 grams of burdock root, cut into small pieces. Insist a day, then boil for 20 minutes, but over low heat. After the oil has cooled, strain it. Keep in a cold place (optimally on the top shelf of the refrigerator) and treat the wound twice a day,
- Pour 50 grams of eucalyptus leaves with a half liter of boiling water. Leave in a thermos for thirty minutes, then strain. Add two tablespoons of honey. A decoction is used as lotions.
- A decoction of burdock root will help strengthen the body. To prepare it, take 10 grams of root. Pour 200 milliliters of water and simmer for 5 minutes over low heat. Drink strained broth in a tablespoon three times a day.
Torsion of the testis hydatide in children is a condition in which the twisting of the thin leg of the hydatide is diagnosed. It can only be treated surgically, the intervention is considered simple. Sutures are removed after 7 to 10 days after the intervention.
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Pathology is caused by external factors: injury or hypothermia. Sometimes chronic inflammatory processes or congenital defects in the formation of connective tissue lead to it (pathology can occur even in a newborn).
Torsion of testis hydatides: causes, symptoms, treatment
Torsion of testis hydatides is a pathology caused by the twisting of the epididymis around its leg. Any man, and even a child, can face a similar disease.
Testicular hydatide is a rudiment located near its upper pole.
The testicular rudiment has a different name - the appendix, but in order not to confuse it with the appendix of the abdominal cavity, it is called hydatide.
We will talk about why testicular hydatide torsion occurs, who is affected by this condition, what is the syndrome of acute scrotum and how to treat the disease, in this article.
Why does this ailment arise?
In fact, testicular hydatide is not a pathology. Moreover, it does not cause discomfort to a man, therefore, he may not even realize that he has such a condition. But if the testicular hydatide twisted around the legs, this condition threatens human health, as the scrotum is injured.
This kind of ailment can lead to necrosis.
It is also worth noting that torsion occurs not only due to testicular injuries. Also, this condition causes a banal hypothermia. At low temperatures, the testicle is involuntarily raised due to intense muscle contraction.
The presented ailment can often be observed in children. This is due to the fact that their connective tissue is not yet mature and prone to deformation. It also has a greater amount of fluid than in adults. Moreover, in children the nervous regulation of muscles is not so developed, so even light strokes (or falling on the scrotum) can lead to such a problem.
Torsion of testis hydatides: symptoms and signs
Symptoms directly depend on the degree of the disease. At the stage of occurrence, when only the process of torsion occurs without clamping the nerve endings, the patient does not feel any promises. Its erectile function remains unchanged, urination is painless, and there are no visual signs.
But after a few days, a man can observe pain in the left or right scrotum. If the pain is localized in only one part of the testicle, then this indicates the initial stage of the disease. Often there is a slight swelling of the organ and redness of the epidermis.
The second degree of the disease is characterized by more distinct pain syndromes in the scrotum. Puffiness in this case decreases, but a neoplasm appears in a form similar to beans. This part becomes very vulnerable (from the touch begins an intolerable pain).
It is worth saying that the ailment presented is developing very slowly, without causing inconvenience to humans. But the consequences that it carries with it can adversely affect the health of men.
You can catch this condition at an early stage. Torsion is noted by a symptom such as a blue dot.
That is, the resulting seal can be felt upon palpation or by illuminating the light to see the blue dot, which indicates the presence of testicular gadatide.
Often torsion of the spermatic cord causes acute scrotum syndrome. If you do not notice this ailment in time, it leads to an inflammatory process in the epididymis.
The pain manifests itself suddenly and very sharply, giving back to the inguinal zone. During movements, pain intensifies in the groin and thigh.
After a few hours, the pendants die off, and the pain decreases, but after a few days, inflammation begins in the testicle and appendage.
A person can observe a visual increase in the scrotum. On examination (palpation), you can feel a small nodule that begins to hurt when touched. Acute scrotum syndrome is a fairly serious consequence of torsion, which can be treated with surgical intervention.
Necrosis occurs if a person untimely turned to doctors for help. If delayed with the treatment of the disease, it can even lead to the removal of the scrotum.Typically, necrosis is manifested in the last degree of torsion of the spermatic cord. The patient's condition is characterized by fever, as well as nausea and vomiting.
Rehabilitation after surgery
In order not to organize infection of the scrotum with an infection, the patient is immediately prescribed a course of antibiotic treatment. At the same time, considerable attention should be paid to the hygiene of the seam. It is necessary to do constant dressings and wash the seam with antiseptics. Postoperative sutures are removed after seven days.
The presented operation is not traumatic and uncomplicated, therefore, wearing elastic supporting swimming trunks is not necessary. The bandage should be worn only according to the doctor’s testimony, if he sees that the patient needs him. Often a procedure such as UHF (organ warming with light) is suggested. It contributes to a speedy recovery. The session lasts no more than 20 minutes.
During the rehabilitation period, it is important not to catch a cold. A virus or infection can adversely affect the healing process. Do not strongly insulate the inguinal region, because the skin must breathe.
But at the same time, hypothermia can cause inflammation.
Therefore, doctors recommend that within two weeks after the operation do not drink cold drinks, especially not to wash with cold water, observe bed rest.
Brief medical history
Testicular hydatide is a vestige and does not cause any problems until it twists around the legs. This leads to injury to the scrotum and its necrosis. This disease is often found in childhood, as their connective tissue contains a lot of fluid. In addition, the muscles of children are characterized by weak nervous regulation.
Prevalence and relevance
This disease belongs to the category of widespread, while it most often occurs in children and young men.
The significance of the disease is associated with the serious consequences to which it can lead. Therefore, a doctor’s examination when the first signs of the disease appear is the first priority.
This disease can lead to complications only if treatment is not timely performed or it is prescribed incorrectly. Most often, the so-called purulent melting of hydatides occurs. As a result of this, pus appears in the scrotum, which may result in the removal of the testicle or scrotum itself.
The danger is also possible blood poisoning, which manifests itself in high temperature, sweating, fatigue, drowsiness and lethargy. Everything can end with a patient getting into a toxic coma and his death.
Most often, local complications occur that may result from an improperly performed operation. When dressing during the surgical intervention of the vas deferens, a serious complication will be a violation of spermatogenesis and subsequent infertility. Another negative consequence of the disease is temporary or permanent erectile dysfunction.
Video: “Torsion of hydatides (18+)”
Torsion of the testicles in a teenager
The occurrence of pain in the groin, testicle in adolescent boys is often explained by physical exertion. Many adolescents love to play sports, are active in everyday life, but few suspect that it is hyperactive behavior, a high return to sports that can cause the development of a dangerous pathology. Not protecting their genitals from injuries, dealing with excessive loads for their age, boys provoke health complications of the reproductive system.
When the spermatic cord or epididymis is infringed, the teenager feels a cutting, tingling pain in the testicle, the scrotum on the one hand increases in size (photo 2), acquires a blue or red color, the asymmetric scrotum resembles a hydrocele in appearance.
Symptoms and methods of diagnosis
Torsion hydatide is expressed in the following symptoms:
- scrotal edema
- its redness, which is characteristic of the initial stage of the disease,
- the appearance of a formation with a crimson hue, soreness when touching a hydatide,
- testicular pain
- high body temperature.
Torsion of testis hydatide proceeds in 3 stages.
At the first stage of the disease pain syndrome in the scrotum and its edema, which appears along with redness, are clearly visible.
In the second stage diseases, one can observe a decrease in edema and a pronounced hydatide in the form of an oblong formation. In this case, pressing with her fingers on it leads to severe pain. The doctor on this prescribes treatment with medications.
Without treatment, the third stagein which necrosis of the hydatid tissue and testicle occurs. Pus appears in the scrotum, as a result of which it has to be removed.
Naturally, even at the first signs of the disease, you need to see a doctor, as this will avoid dangerous complications. Boys need to be treated carefully, as they tend to hide health problems, especially in adolescence.
Diagnosis of the disease can be carried out at an early stage. It represents the following events,
- examination of the child by a doctor,
- palpation of a sore spot
- puncture taking
- Ultrasound This method of examining the patient helps to find the location of the formation and its size. Ultrasound can also determine the best place for an incision during surgery,
- diaphanoscopy is the scintillation of the scrotum with a flashlight, as a result of which it is easy to detect blackout in the form of a bean. It is the epididymis, which has changed as a result of the disease.
Video: "Torsion of the testicle"
Basically, testicular torsion hydatides in boys are treated as a result of surgical intervention.
In the postoperative period, antibiotics are prescribed, for example, Ampicillin. This is to prevent further infection of the wound.
For the treatment of wounds, antiseptic drugs, for example, an alcoholic solution of iodine, are used. Also, after surgery, doctors often prescribe galvanization, UHF, and magnetotherapy.
After the operation, you need to protect the child from colds in order to avoid complications. You should also not swim in cool water and drink cold drinks.
Torsion of the testicle in an adult
The health problems of the testes in an adult male are related to the type of professional activity, regularity of sexual relations, lifestyle, and the presence of chronic diseases. Most often, testicular torsion is diagnosed in active men 30-45 years old. For many of them, an unexpected manifestation of pathology is unexpected.
A sharp piercing pain can occur in a dream, when performing heavy physical work, while experiencing stress and excitement. In adult men, multiple self-eliminating infringement of the testes is often observed, which leads to irreversible twisting of the spermatic cord, requiring surgical intervention.
Signs of testicular torsion in men and children
The primary signs of testis torsion can be different in adults and children due to the different etiology of the pathological process. To recognize a dangerous disease, you need to know:
- what is testicular torsion, how is the infringement of the spermatic cord,
- what it threatens
- how this pathology is eliminated.
From what happens testicular torsion, signs of primary manifestation
Unfortunately, many men, youths and teenagers think about the health of their genitals only after they face serious consequences after their illnesses.Torsion of the testicles is no exception. The number of cases of detection of this pathology is growing sharply due to the lack of a culture of preserving male dignity from the influence of harmful external factors.
- The most common cause of infringement of the testes among adult men and children is injuries. When the scrotum is bruised, the testicle may move, blood vessels may be damaged, and the muscles of the scrotum may be affected.
- Hypothermia of the organs of the reproductive system contributes to the disruption of the functioning of the muscles responsible for raising the testicle, muscle cramps provoke an irreversible spin of the spermatic cord.
- Overheating of the scrotum organs, as well as hypothermia, can be the cause of the development of pathological processes. For example, the resulting adhesions violate the full structure of the structure of the scrotum, which can provoke an infringement of its organs.
- Excessive physical exertion (heavy lifting, heavy physical work, intense training associated with muscle tension in the press) can provoke torsion of the testicle. In boys, the causes of infringement of the testes can also be reduced to congenital anomalies.
In medical practice, there are cases when it is impossible to establish the cause of the development of pathology. Therefore, to be sure that this problem will never affect the health of a man is wrong.
The primary signs of manifestation of testicular torsion make themselves felt long before the onset of an acute course of pathology, these include:
- physical ailment, which is associated with fatigue,
- problems with urination
- chills, which are taken for a cold,
- bouts of nausea
- jumps in blood pressure,
- short-term periodic pulling pain, giving in the groin.
The primary signs of pathology do not attract proper attention, since they are perceived as a symptomatology of concomitant diseases, a manifestation of chronic ailments of the genital organs. Many men and boys' parents only when examined by a specialist will find out what constitutes testicular torsion. Symptoms in a teenager and adult man, indicating a pinching of the testicle due to the development of inflammation, are more pronounced than in a preschool child. Aching pain in the scrotum can occasionally bother the young man, often after hypothermia of the testicles. In men, periodic pain in one of the testicles is observed with physical overwork.
Ⅱ. Secondary signs of looping testicles
At the same time, symptoms (photo 3) of the secondary order help diagnose testicular torsion.
- scrotal swelling
- palpable soft structure of the testicle:
- formation of scrotum on one side,
- scrotal soreness when touched,
- visible asymmetry of the scrotum - one testicle is located much higher than the second,
- increased temperature of the testicles.
Torsion of the testis - what does the pathology look like?
In order to know how to help yourself and not waste time waiting for the improvement of the condition with manifestations of infringements that adversely affect the health of the man, you should know what the testicular torsion looks like. The characteristic externally manifested signs of the disease are reduced to a change in the shape of the scrotum:
- swollen scrotum on the one hand
- discoloration of the skin of the scrotum sac (red or blue),
- drooping scrotum, as with hydrocele.
Indications of testicular torsion (photo 4), symptoms of external manifestation state the last phase of the irreversible twisting of the testis, during which the patient needs emergency medical care aimed at saving the viability of the testicular tissue through surgery.
It is with the manifestation of obvious external signs of testicular torsion in the patient:
- body temperature rises
- vomiting opens
- there is dizziness
- a person loses his temper
- the pain is so sharp and intense that a man or boy may lose consciousness.
Testicular torsion - how to treat?
The time to assist the patient with torsion testicles is too limited. Within six hours after the onset of the first severe symptoms of the disease, the prognosis of treatment is positive. The chances of preventing necrosis and atrophy of the testes are high. If the patient suffered pain in the hope of improving the condition for more than six hours, in most cases the negative processes are irreversible, but the operation is required to eliminate the atrophied testicle in order to prevent sepsis.
The choice of treatment for testicle infringement depends on the age of the patient. In older children, young men, adult men, testicular torsion is eliminated by performing an operation that provides access to the pathological focus through the scrotum. Possible postoperative complications of infringement of testicles are infertility, hormonal failure, and the development of cancer.
When operating infants, newborn boys, specialists resort to surgical intervention through the groin. In infancy, surgery is easier to carry out, in most cases with the right tactics of specialists without subsequent complications.
After eliminating the painful pathology, both men and boys are prescribed drug therapy, and if necessary hormone therapy.
Torsion of the testis of the newborn: features, treatment
Torsion of the testis of a newborn baby is detected either during childbirth, or within a few hours after them. Congenital pathology can develop when the child is still in the womb.
- In the first hours of birth, if there is a congenital anomaly in the structure of the organs of the scrotum, its deformation is detected in the child.
- One testicle can be significantly larger than the second and located much higher relative to the second.
- At the same time, the scrotum is characterized by swelling.
- From the side of edema or swelling, the scrotum acquires a dark blue color resembling a hematoma.
The painful syndrome rarely makes itself felt, in infants, the torsion of the testes is often accompanied by an increase in body temperature and frequent spitting up, turning into severe vomiting.
Congenital pathology may not be detected during the stay of the baby with the mother in the hospital and make itself felt much later, as a result of tight swaddling, sudden movements of the baby.
To confirm the diagnosis in the baby, additional diagnosis of testicular torsion is required. So the child is assigned an ultrasound examination of the genitals and pelvic organs, dopplerography of the scrotum vessels.
The elimination of the pathology of the testes in newborns is possible either by the method of detorsion or by surgery.
☑️ A common disease among puberty boys is testicular hydatide necrosis
Morgagni hydatida necrosis is a common but little-known disease. The timeliness of the performed surgical treatment is the prevention of infertility in the future.
Testicular hydatide necrosis (or Morgagni hydatide) is a disease characterized by torsion of the rudimentary organs on the testicle - Morgagni hydatides - with their subsequent death and possible involvement in the pathological process of the testicles and its appendages.
Morgagni hydatide is a rudimentary secondary formation resulting from testicular embryogenesis during incomplete reduction of the Muller duct. The hydatide has a lobed structure, attached to the testicle with a thin leg.
Diagnosis of testicular torsion in a newborn
Congenital pathology in infants is often detected immediately after childbirth. A dangerous condition in newborns is determined by the significant asymmetry of the scrotum. What the doctor first draws attention when examining the baby is the following points:
- the testicles are lowered into the scrotum,
- what size are they
- assesses the baby’s reaction to touching the scrotum,
- how the testes rise and fall,
- whether the color of one half of the scrotum is changed, whether its cavities are enlarged.
If, against the background of asymmetry of the scrotum sac, one of its chambers enlarges, the scrotum skin changes color - it turns blue or red, the child rises in temperature, vomiting opens, then specialists prescribe an urgent ultrasound of the scrotum and perform diaphanoscopy, based on the results, they diagnose testicular torsion code according to ICD-10-№44, decide on the operation of the baby.
Torsion of the testis in a child (photo 2) in a newborn baby can be eliminated with the help of detorsia - manual manipulation. A successful testicle adjustment does not guarantee the absence of relapse if the testis, due to the anatomical features of the structure of the scrotum organs, is not attached to its wall, which allows it to freely rotate around the vertical and horizontal axis, infringing on the vessels and nerves of the spermatic cord, on which it rests.
How is testicular torsion diagnosed by ICD-10-No. 44 in preteen and adolescent boys?
Complaints of boys about acute pain in the testicle should not be overlooked by parents. Often a child goes to a specialist several hours after the first signs of testicular torsion, which significantly reduces the chances of saving the testicle. By the time the doctor examines the scrotum, it has time to not only turn blue, but also significantly increase in size, painful swelling may be similar to a hydrocele (photo 3).
- Assistance to the patient begins with a detailed medical history: information about diseases, the frequency of complaints of scrotum pain, concomitant ailments, and scrotal injuries. During the examination of the scrotum, the specialist performs palpation of the scrotum, determines the pulsation of the testicle at the upper edge of the scrotum.
Of course, for the doctor, the pain of the scrotum of the boy and its increase in size is a weighty argument for referring the patient to diagnostic procedures, the results of which can be obtained in a few minutes after they are performed. So, ultrasound diagnostics of the scrotum and diaphanoscopy in case of suspected testicular torsion is appropriate. Ultrasound signs of pathology are reduced to detecting a lack of blood flow in the testicle body, an increase in the scrotum cavity due to fluid accumulation, and the formation of a hematoma in the case of intramuscular hemorrhage.
Diaphanoscopy allows you to determine the viability of the testis. If during transillumination of the testicle it transmits light, then the chances of a successful outcome of the operation are great. If the testicle does not pass through the glow - the doctors diagnose atrophy of the testis, which requires surgery to remove it.
By eliminating the development of diseases similar in symptomatology using methods of clinical and instrumental diagnostics, confirming the diagnosis of the disease code ICD-10-No.44 testicular torsion for ultrasound, specialists decide on the operable elimination of the pathology.
Torsion of the testis ICD code No. 44: diagnosis in boys and men
In the diagnosis of testicular twisting in young men and adult men, it is appropriate to collect a detailed history of the patient. Information is important for specialists:
- about the regularity of a man’s sexual life,
- possible signs of difficulty urinating,
- whether injuries occurred prior to the manifestation of the primary symptomatology of the disease state of the scrotum,
- are there any chronic diseases
- did a man have sexually transmitted diseases
- how many hours have passed from the onset of acute pain in the scrotum,
- what is their intensity.
When diagnosing testicular torsion in adult men, it is important to exclude, possibly making themselves felt by acute symptoms, diseases of other body systems - abdominal organs, kidneys, and gastrointestinal tract.To this end, specialists resort to ultrasound examination of the genital and adjacent organs, computed tomography, magnetic resonance imaging, dopplerography of the vessels of the testis.
Torsion of the testicle, or rather its appendage or spermatic cord - this is not the whole list of infringements detected by specialists in men in the process of medical practice. So, in recent years, cases of revealing such a diagnosis as testicular hydatide torsion have become more frequent. ICD-10 also includes this pathology in the group of testis diseases under No. 44.
Hydatides are vesicular formations having a connecting leg with an epididymis; their infringement also threatens atrophy of the testicle due to a violation of the process of full blood supply. Hydatides are often diagnosed with an ultrasound of the scrotum, in the ultrasound image they are darkened areas viewed along the contour of the body and epididymis. Formations on the legs from the outside on the testes are a deviation from the norm of the anatomical structure of the testicles. If hydatides provoked torsion of the testicle (expert reviews focus on this), urgent surgery is required to resume blood supply in the infringed area.
An integrated approach to the study of testicular torsion in men - the use of both clinical, instrumental, and differential diagnostics makes it possible to assess the complexity of the situation:
- determine the location of the pathological focus,
- establish the type of torsion (appendage, spermatic cord, hydatide),
- check the usefulness of the blood flow in the testicular tissue,
and take effective measures to eliminate it without further complications.
Torsion of the right testicle: treatment
When infringing on the testicular spermatic cord, it is important to provide emergency assistance to the patient, because the tissues of the testicles, deprived of blood supply, are subject to physiological stress, accompanied by necrosis and atrophy.
Is it possible to eliminate testicular torsion medically? Treatment of infringement of the appendages, spermatic cord involves the use of two methods:
- manual adjustment of the testis - allowed in the first hours of torsion,
- surgical intervention - the operation is advisable if the testis could not be set using detorsion.
With manifestations of acute painful symptoms, experts do not recommend taking painkillers. They turn out to be powerless with a complete torsion of the testis or can smear the picture of the state with spontaneous elimination of infringements. Self-resolving pathological processes ultimately lead to irreversible infringement, therefore, for any pain in the scrotum, specialist consultation and examination of the scrotum organs is required.
Torsion of the right testis is treated in the same ways as infringement of the left testis. What method of treatment for men to resort to, the doctor decides, based on the complexity of the symptoms of the disease. But, as medical practice shows, surgery is the only way to save the viability of male testicles.
In turn, testicular torsion can cause varicocele. If you see a doctor a day after the torsion, the affected testicle cannot be saved. In a similar case, laparoscopic surgery is performed to treat varicocele. When performing varicocele removal using laparoscopy, a video camera is inserted into the abdominal cavity, which allows us to find out the cause of the deterioration of the condition of the man.
Laparoscopic surgery to remove varicocele has many advantages:
- Quick recovery of a man after laparoscopy of varicocele.
- Minimal complications.
- Good tolerance by the body.
- Speed of elimination of varicocele.
- Lack of cosmetic defects.
- Short anesthesia
With varicocele, laparoscopy is the most effective way to combat this disease. Laparoscopic treatment of varicocele helps to restore full sexual function during the first week. There is also a significant increase in healthy sperm. This quality of operation is used to improve conception.
Testicular torsion: operation
If the specialist manages to manually eliminate the testicular torsion using the detorsion method, the operation may not be necessary. Detorsion is appropriate during the first hours of the manifestation of pathology.
If more than six hours have passed since the first symptoms, it increases the chances of saving the testes and eliminates testicular torsion only. Surgical intervention allows you to:
- assess the degree of twisting of the spermatic cord,
- restore its patency,
- determine the feasibility of a complete testicular resection.
Testicular surgery is performed under general anesthesia. Its execution time depends on the viability of the testis. If the testicle "has not died", unwinding of the spermatic cord is performed, monitoring the resumption of full blood flow, suturing. If the tissues of the testis are not viable when the scrotum is cut, the testis is removed in order to prevent the development of sepsis.
Postoperative complications of testicular torsion are:
- inferiority complex,
- irreversible male infertility
- oncology of the scrotum organs.