Torsion of the spermatic cord - causes and symptoms Torsion of the spermatic cord

This pathology is usually unilateral. In medical practice, cases of a bilateral process are rarely recorded.

Urologists distinguish two main forms:

• extra-vaginal torsion of the spermatic cord;
• intra-vaginal.

Extra-vaginal torsion is a twisting of the testicle together with its membranes. The most important role in the development of this disease is played by the morphological immaturity of the structure of the testicle itself and the tissues surrounding it.

Intra-vaginal is a twisting in the cavity of the vaginal membrane. Most often, the disease manifests itself in children over 3 years old. The peak of such a problem falls on boys from ten to sixteen years old.

Causes

This disease is caused by:

• lack of fixation in a normal position (due to injury or congenital causes);
• jumping;
• abdominal tension;
• sudden movements;
• injury, bruise of the scrotum.

Symptoms

This pathology is characterized by unexpected, very severe pain in the groin area, vomiting, discomfort in the abdomen. Also noted is a cold focus, hyperemia and swelling of the scrotum, upward tightening of the testicle, fever. The patient may feel general weakness and malaise, painful sensations upon palpation and probing in the right or left iliac region, increased pain when lifting the scrotum.

Diagnostics

Ultrasound diagnostics of the scrotum is not prescribed, since the changes that are present in the patient at an early stage are not visible. The urologist sends the patient to do a testicular scintigraphy. This technique provides reliable information about the torsion of the above-mentioned structures by 84%. To exclude the possibility of infection, the specialist prescribes the patient a clinical blood and urine test.

Treatment

Treatment consists of surgical intervention. It is very important that the operation take place in the first four hours of the patient's pain, since after six hours the death of ischemic structures (necrosis) occurs. It is very important to remember the following: in eighty percent of cases the testicle remains viable after torsion for only six hours, and only in twenty percent of cases for ten hours. Therefore, do not sit at home and do not self-medicate, because the consequences may be unfavorable.

The urologist untwists the patient's spermatic cord (detorsion is performed), the viable organ returns to its original position. If the testicle has retained its viability, the urologist performs a procedure called orchiopexy (suturing). If it is not viable (necrosis), then it has to be removed (orchiectomy).

In 2-3% of cases, when torsion is diagnosed in men, the disease can be cured immediately and without surgery (in the first few hours).

In such cases, external manual detorsion is performed.

During the rehabilitation period, the specialist prescribes sensitizing substances, physiotherapy and drugs that normalize microcirculation in the damaged organ.

To reduce the permeability of the hemotesticular barrier during rehabilitation, the doctor prescribes acetylsalicylic acid to the patient.

Prevention

Today, doctors find it difficult to name the only reason that leads to obstruction of the vas deferens, so preventive measures are not developed today.