All predispose to torsion testis, except:
Ans: b (Epididymo orchitis) Ref: Bailey & Love, 24th ed, p. 1405Epididymo orchitis does not predispose to torsion testisPredisposing factors for torsion of testisa) Inversion of the testis (most common)b) High investment of the tunica vaginalis cause testis to hang within the tunica like a clapper in a bellc) Separation of the epididymis from the body of the testis permits torsion of the testis without involving the cord. Twisting is confined to the pedicle which connects the testis with the epididymisMost common b/w 10 & 25 yrs of age- Prehn signOn elevation of testisPain increases - in torsionPain decreases -in epididymo orchitisPyuria is associated with Epididymo orchitis, not with torsion testisInv of choiceColour Doppler- detects the decreased blood flow to testis in torsionTc 99 pertechnate scan - demonstrates decreased blood flowTreatment:1) In the 1st hr torsion can be treated by manipulation, (but later on surgery is done to fix testis)2) If not correctable by manipulation or more than one hr has passed, then surgery has to be done. Surgery must be done within 4 hrs. otherwise testis will be dead.3) Both affected & unaffected testis should undergo orchidopexy because anatomical variation responsible for torsion is likely to be bilateral.
Inversion testis
Epididymo orchitis
High investment of tunica vaginalis
Separation of epididymis from body of testis
Testis & Scrotum