Surg: Testicular Torsion: Free MSRA Podcast

🏥 Testicular Torsion: UROLOGICAL EMERGENCY 🚨🚦 The EssentialsTesticular torsion = twisting of the spermatic cord → blood supply cut off!Think: “Twisting cord, blood flow ignored.”💡 Most common in males 10–30 yrs (peak: 13–16), but can happen at any age (including neonates). 🧬 Why Does It Happen?Bell clapper deformity (testicle free to twist)🧬 Family history/genetic factors💥 Sudden movement, trauma, or sometimes no obvious trigger 🚩 Classic RED FLAGS⚡️ Sudden, severe, one-sided testicular pain (may wake from sleep)💥 Scrotal swelling & redness🤢 Nausea & vomiting❌ Absent cremasteric reflex (no upward movement when inner thigh stroked)🔝 High-riding, horizontal testisHistory of previous similar pain? (suggests intermittent torsion!) 🩺 Key DifferentialsEpididymo-orchitis (usually older, slower onset, urinary/STI signs)Torsion of appendix testis (blue dot sign)Trauma, hernia, tumour (usually painless, gradual), hydroceleMnemonic: Severe pain, swollen & red, reflex fled 📈 EpidemiologyIncidence: ~1 in 4,000 males <25Peak: AdolescenceTime = Testicle: 6hr = 90–100% salvage; >12hr = 50% or less! 🩻 InvestigationsClinical diagnosis is KING 👑 – don’t delay!🔊 Doppler ultrasound: Absence of blood flow (can help but don’t delay surgery if high suspicion)🧪 Urinalysis: Rule out infectionUK/US guidelines:If clinicalsuspicion is high, immediate surgicalexploration—do NOT wait for scan. 🔪 ManagementEMERGENCY SURGERY: Detorsion + orchidopexy (fix both sides)Attempt manual detorsion only if immediate surgery not available (temporary)Orchidectomy if testis is non-viableProsthesis option later if neededMnemonic: “Six-hour window, high-win ratio” 😱 ComplicationsTesticular loss/atrophy (irreversible tissue death)Infertility/subfertility (can affect both testes via immune response)Recurrence if not fixedPsychological distressInfection/abscess if tissue necrosis 📝 Quick Revision LinksRevision Notes:https://www.passthemsra.com/topic/testicular-torsion-revision-notes/Flashcards:https://www.passthemsra.com/topic/testicular-torsion-flashcards/Accordion Q&A:https://www.passthemsra.com/topic/testicular-torsion-accordion-qa-notes/Rapid Quiz:https://www.passthemsra.com/topic/testicular-torsion-rapid-quiz/Full Quiz:https://www.passthemsra.com/quizzes/testicular-torsion/More free resources:https://www.passthemsra.comhttps://www.freemsra.com 🔑 TAKEAWAYSudden testicular pain = torsion until proven otherwise!ACT FAST: Every minute counts for testicular survival & fertility!🚑 If in doubt, get help—no delay! #MSRA#TesticularTorsion #Urology #Emergency #MSRARevision #Surgery #SaveTheTesticle 🚨🍳🩺