Testis Ectopic & Torsion

Ectopic Testis

      Favourite sites of testicular ectopia (abnormal position) are superficial inguinal pouch, prepubic, femoral or perineal positions (Fig. 27.3a). Surgical correct positioning should be accomplished early.

4. Torsion

      Torsion or twist of the spermatic cord is the result of a larger mesentery of the testis allowing the testicle to twist freely within the scrotum.

*     If rotation exceeds 90o, it results in stopping of the blood supply

*     The patient presents with extreme pain of suddent onset and if allowed to continue for more than 4 hours results in gangrene and subsequent atrophy of the testicle, thus the need for early surgery.

*     Torsion should be suspected if there is rapid onset of severe pain, swelling of testis. Nausea, vomiting and occasionally fever is seen.

*     Involved testis is rather high in the scroptum and horizontal in position

*     Differential diagnosis between torsion and epidydimitis is possible, in case of torsion the entire testicle and appendages are involved in the swelling process, in epididymits, induration is confined to epididymis.

4.1 Prompt surgical intervention is required in a case of torsion. Derotation and fixation of testis it is if viable.

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