Paediatrics: Testicular Torsion: Free MSRA Podcast

🩺 FREE MSRA PODCAST – Torsion of Testis: Don’t Miss This Surgical Emergency! ⚡Today’s episode delivers the must-know facts on testicular torsion—an absolute paediatric and adolescent emergency. We cover the high-yield essentials for your MSRA revision and clinical practice: from classic features to urgent management, memory tips included!🧠 Key Learning Points📌 Definition• Torsion of testis = twisting of the spermatic cord → sudden blockage of blood flow• Results in acute, severe pain and rapid testicular damage📌 Causes & Risk Factors• Intravaginal torsion – most common, esp. in adolescents (12–18 years), linked to “bell clapper deformity” (testis not anchored, free to rotate)• Extravaginal torsion – newborns, testis + tunica twist together (pre-fixed descent)• Risk factors: anatomical variants, previous episodes, family history📌 Pathophysiology• Twist → blocked blood flow → ischaemia → rapid irreversible damage if not fixed• Golden window: <6 hours for best chance of salvage (90–100%); drops <10% after 12–24 hrs📌 Differential Diagnosis• Torsion of appendage, epididymitis/orchitis, hydrocele, hernia, trauma, mumps orchitis, tumour📌 Epidemiology• Peak: teenagers (13–16 years)• ~1 in 4000 males <25 years (UK & US data)• Trauma = rare cause; most cases spontaneous📌 Clinical Features• Sudden, severe testicular pain (± lower abdo pain, nausea/vomiting)• Swollen, high-riding, tender testicle• Horizontal lie, absent cremasteric reflex (key sign!)• No relief with elevation (Prehn’s sign negative)• Urgent: Any acute scrotal pain in young male = torsion until proven otherwise📌 Diagnosis• Primarily clinical — act on suspicion, don’t delay!• Doppler US: ↓/absent blood flow, “whirlpool sign” (if time allows)• UK guidelines: Do not delay surgery for imaging if high suspicion📌 Management• Immediate surgical exploration (detorsion + bilateral orchidopexy)• Manual detorsion (outward rotation) only if surgery is delayed—not definitive• Keep patient nil by mouth, give analgesia, urgent urology referral📌 Complications• Testicular infarction & atrophy (shrinkage)• Subfertility (even after salvage, up to 36–39%)• Recurrence if not fixed• Orchidectomy (removal) if non-viable📝 Mnemonic:T-I-M-E:Torsion,Ischemia,Minutes matter (<6hr window!),Emergency surgery📎 More MSRA Resources for Torsion of Testis:📝 Revision Notes: https://www.passthemsra.com/topic/torsion-of-testis-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/torsion-of-testis-flashcards/💬 Accordion Q&A: https://www.passthemsra.com/topic/torsion-of-testis-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/torsion-of-testis-rapid-quiz/🎓 Paediatrics Course: https://www.passthemsra.com/courses/paediatrics-for-the-msra/#MSRA #Paediatrics #TorsionOfTestis #TesticularTorsion #SurgicalEmergency #MSRAQuiz #PassTheMSRA #FreeMSRA #AcuteScrotum #ChildHealth #NICEguidelines