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Fulltext Trauma induced testicular torsion: a reminder for the unwary

Yeap JS, Moissinac K

J Accid Emerg Med, 2000 Sep;17(5):381-2.
PMID: 11005420

Trauma induced testicular torsion is a well recognised entity, the incidence being 4-8% in most studies reporting on testicular torsion. The signs and symptoms of testicular torsion may easily be mistakenly attributed to preceding testicular trauma if there was such an event. A patient is described with trauma induced testicular torsion who presented on three occasions before a decision was made to perform scrotal exploration. Unfortunately, an orchidectomy was the outcome. The message that trauma can and not infrequently does precipitate torsion, needs to be reiterated. Awareness of the entity and constant vigilance is required of clinicians to avoid a delay in definitive treatment.

Matched MeSH terms: Spermatic Cord Torsion/diagnosis; Spermatic Cord Torsion/etiology*; Spermatic Cord Torsion/surgery
A case of neonatal testicular torsion

Wong CY, Yong SC, Boo NY, Phang KS

Hosp Med, 2005 Jun;66(6):368-9.
PMID: 15974173 DOI: 10.12968/hmed.2005.66.6.18409
Matched MeSH terms: Spermatic Cord Torsion/pathology*; Spermatic Cord Torsion/surgery
Torsion of the testes: a review of 24 cases

Juat WT, Hin OT, Somasundaram K

Med J Malaysia, 1977 Dec;32(2):168-71.
PMID: 614487
Matched MeSH terms: Spermatic Cord Torsion/diagnosis*
Correlation of ultrasonography and surgical outcome in patients with testicular torsion

Burud IAS, Alsagoff SMI, Ganesin R, Selvam ST, Zakaria NAB, Tata MD

Pan Afr Med J, 2020;36:45.
PMID: 32774621 DOI: 10.11604/pamj.2020.36.45.21824

Introduction: Testicular torsion is a surgical emergency that is caused by twisting of the spermatic cord and its content. This condition causes irreversible changes after 6 hours. Early recognition and management of testicular torsion is important for testicular salvage and preservation of fertility.
Methods: This is a retrospective study done on all patients who presented with acute scrotal pain from January 2013 to December 2017. The data collected included the patient's age, symptoms, the time duration between the onset, ultrasound, and surgery, ultrasound findings with Doppler and the surgical intervention. Statistical analysis was performed using SPSS 25.0. Data are presented as mean (SD) values. Differences between groups and predictive values were calculated using Chi-square, t-test and Mann-Whitney U-test and are expressed by value with 95% CI.
Results: The total number of patients who presented with acute scrotal pain were 88. Testicular torsion was diagnosed in 55 (62.50%) of the patients, 17 (19.32%) had epididymis-orchitis, 5 (5.68%) had torsion of appendage/cyst, and 11 (12.50%) had normal testis. Ultrasound has a sensitivity and specificity of 88.24% and 68.40% respectively. It is a good tool to detect testicular torsion but it is operator dependent. Positive predictive value was 83.33% and negative predictive value was 76.47%. When ultrasound is combined with clinical findings the rate of negative exploration is reduced by 10%.
Conclusion: Good medical history, appropriate clinical evaluation and performing an ultrasound of the scrotum are important in testicular torsion. US evaluation in cases presented after 24 hours does not change the outcome.

Matched MeSH terms: Spermatic Cord; Spermatic Cord Torsion
Testicular torsion

Koh KB, Dublin N, Light T

Aust N Z J Surg, 1995 Sep;65(9):645-6.
PMID: 7575294

A retrospective review of 80 patients who underwent scrotal exploration for presumed testicular torsion is presented. Of these, 67 patients were found to have torsion, and the testicular loss rate was 51%. Patients who experienced delays in scrotal exploration of more than 24 h from onset of symptoms had a testicular loss rate of 71%. These delays arose from both hesitation in seeking medical treatment and misdiagnoses. It is emphasized that an acute scrotum in a child or in an adolescent should be explored early to exclude torsion.

Matched MeSH terms: Spermatic Cord Torsion/diagnosis; Spermatic Cord Torsion/surgery*
A case of abdominal testis complicated by tumour formation and acute torsion of the cord

Chitty EC

Malayan Medical Journal, 1933;8:203.

Matched MeSH terms: Spermatic Cord Torsion
Innervation of the scrotum by the anterior division of the obturator nerve - a rare variation

Nayak SB, Vasudeva SK

Morphologie, 2021 Apr 16.
PMID: 33875370 DOI: 10.1016/j.morpho.2021.03.005

The scrotum is supplied by ilioinguinal, genital branch of genitofemoral, perineal branch of the posterior cutaneous nerve of the thigh and the posterior scrotal branches of the pudendal nerve. We report an extremely rare innervation of the anterior part of the scrotum by the anterior division of the right obturator nerve. The genital branch of genitofemoral nerve did not reach the scrotum. The ilioinguinal nerve did not supply the scrotum. The anterior division of the obturator nerve gave a branch which ascended superomedially in the thigh, crossed superficial to the spermatic cord and communicated with the right ilioinguinal nerve. As it crossed the spermatic cord, it gave a scrotal branch which descended over the spermatic cord and ramified to supply the anterior part of the scrotum. Knowledge of this variation could be important to anaesthesiologists, urologists and surgeons in general.

Matched MeSH terms: Spermatic Cord
Fulltext Imaging modalities for an uncommon inguinal scrotal pathology: A case report and literature review

Chun KH, Inn FX, Hing EY, Hong GE

Urol Ann, 2017 11 10;9(4):387-389.
PMID: 29118545 DOI: 10.4103/UA.UA_69_17

Inguinal scrotal swelling is a common presentation to surgical clinic with various differential diagnoses. In most circumstances, a good clinical assessment is sufficient to identify the diagnosis. Imaging is necessary when diagnostic difficulty was encountered. The choice of imaging study could affect the management and outcome. A 60-year-old male presented with an enlarging right inguinal scrotal swelling for 5 years. Clinical examination showed a swelling extended from the right inguinal region down to the right scrotum, firm, not reducible, and not separable from the right testis. Differential diagnoses range from the malignant testicular tumor, irreducible inguinal hernia to the soft-tissue tumor. Ultrasonography and computed tomography scan were unable to conclude the origin of the tumor and involvement of the right testis. Inguinal exploration with potential radical orchiectomy was planned and caused much distress to the patient, resulted in delay in surgery. Intraoperatively, the mass was separated from the testis and spermatic cord, and thus, excision biopsy was performed sparing the testis and spermatic cord. Histopathological examination showed cellular angiofibroma. The right choice of imaging modality is important to provide a precise diagnosis and better treatment plan. This could avoid the unnecessary distress to the patient for potential organ lost. A review through the literature showed the ability of magnetic resonance imaging to better delineate the anatomy of inguinal scrotal soft-tissue mass and thus should have been the imaging modality of choice.

Matched MeSH terms: Spermatic Cord
Histopathological changes of reproductive organs of goats immunized with Corynebacterium pseudotuberculosis killed vaccine

Umer M, Jesse FFA, Mohammed Saleh WM, Chung ELT, Haron AW, Saharee AA, et al.

Microb Pathog, 2020 Dec;149:104539.
PMID: 33007431 DOI: 10.1016/j.micpath.2020.104539

Caseous lymphadenitis (CLA) caused by Corynebacterium pseudotuberculosis is characterized by the development of abscesses, mainly in superficial and internal lymph nodes, visceral and reproductive organs in small ruminants. This study aims to examine the histopathological changes in reproductive organs of goats immunized with killed vaccine of C. pseudotuberculosis. In this study, twenty four (24) clinically healthy bucks and does were divided into four groups A, B, C and D. Animals in groups A and B were immunized with 0.5 and 1% formalin killed vaccine, respectively; followed by a booster dose. After the booster dose of immunization, groups A, B and C were challenged with C. pseudotuberculosis at 106 cfu/ml. Goats in group D were immunize and unchallenged and left as control group. All C. pseudotuberculosis infected animals were euthanized humanely 12 weeks post-challenged. Tissue samples such as testes, epididymis, spermatic cord, penis, pituitary gland, mammary gland, vulva, vagina, cervix, uterus, fallopian tube and ovaries were collected for histopathology study. Microscopic examination of all tissues (testes, seminiferous tubules, spermatic cord, penile tissues and the pituitary gland) in the male reproductive organs of the bucks that were inoculated with 2 ml of 0.5% and 1.0% of C. pseudotuberculosis killed vaccine showed normal (animals inoculated with 1.0%) to mild (animals inoculated with 0.5%) histopathological changes when compared with those from group C which showed varying degrees of histopathological changes (p

Matched MeSH terms: Spermatic Cord