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In testicular torsion the spermatic cord that provides the blood supply to a testicle is twisted, cutting off the blood supply, often causing orchalgia. Prolonged testicular torsion will result in the death of the testicle and surrounding tissues.
Testicular torsion is a medical emergency that needs immediate treatment. While it is more frequent among adolescents, it should be considered in all cases where there is testicular pain. Torsion occurs more frequently in patients who do not have evidence of inflammation or infection.
Emergency testing for torsion may be indicated when the onset of pain is sudden and/or severe, or the test results available during the initial examination do not enable a diagnosis of urethritis or urinary tract infection to be made. An ultrasound scan of the scrotum, if available, is of immense help in the diagnosis. If the diagnosis is questionable, an expert should be consulted immediately, because testicular viability may be compromised.
With prompt diagnosis and treatment the testicle can be saved in a high number of cases (see references below).
It is also believed that torsion occurring during foetal development can lead to the so called vanishing testis, and is one of the causes of an infant being born with monorchism.
In the animated television series The Venture Brothers during the episode "Are you there god? It's me, Dean", the Venture Twins, Hank and Dean, are afflicted with testicular torsion. At the end of the show, the Venture clan do a somewhat sarcastic Public Service Announcement for the "Scrotal Safety Commission" on the malady.
External links
Adapted from the public domain document Centers for Disease Control and Prevention. 1998 Guidelines for Treatment of Sexually Transmitted Diseases. MMWR 1998;47(No. RR-1) at http://wonder.cdc.gov/wonder/STD/STD98TG/STD98T12.HTM and other sources.
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