Showing posts with label spermatic cord. Show all posts
Showing posts with label spermatic cord. Show all posts

Sunday, July 10, 2011

Treat Testicular Torsion Naturally

There are a few alternative treatment in order to cure testicular torsion naturally. The natural treatment will help reduce the risks factor and also do not have recovery time at the same time will reduce the side effects.

Nutrition Therapy
One of the more common in natural treatment of testicular torsion is nutrition therapy. With this mode of treatment, dietary changes are made to your eating habits not only to help fight the disease, but also minimize the side effects of both chemotherapy and radiation while optimizing your overall health.

In the treatment of testicular torsion, nutrition therapy is individualized from person to person, based on a number of factors, such as health, body fat, immune system, staging and medical history (to name a few). However, it usually involves an increase of fruits, vegetables and whole grains as well as yogurt, legumes, fish and poultry. These dietary changes are often coupled with nutritional supplementation of vitamins C and E, selenium, beta carotene and eicosapentaenoic acid, which is a form of omega-3 fatty acid.

Naturopathic Medicine
Another common complementary and alternative medicinal treatment is naturopathic medicine. With this methodology, the whole person is being treated for the disease, not just the cancer itself. Focus is also placed on the mind, the soul and the emotions, as each piece of your being is important to recovery.

Naturopathic medicine frequently entails a combination of nutritional changes, herbal supplementation, physical exercise, deep tissue massage, acupuncture, counseling, stress management, mediation and other alternative practices. These are used in conjunction with Western medicine, such as surgical removal of the tumor (or testicle), chemotherapy and radiation therapy. The variety of different applications doesn’t neglect any facet of your person. It’s essentially creating the healthiest environment, both internally and externally, so you can get well.

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Monday, July 19, 2010

Fertility Preservation Following Torsion And Severe Ischemic Injury Of A Solitary Testis

Testicular Torsion

UroToday.com - One interesting component of this case was that the patient was taking melantonin. We were never able to obtain the dose or the indication for this medication. In researching this subject we discovered a study in which melantonin was used to protect spermatogenesis in rats with injury from testicular ischemia and with reperfusion injury. It was a small study that concluded melatonin acts as an antioxidant helping to protect spermatogenesis during an ischemic-reperfusion injury. This same institution has produced several studies in rats that favor a protective effect of melatonin. We were unable to find any information on melatonin in human cases.

An obstacle encountered during this patient's care was the discussion of sperm banking. This is not an easy subject to discuss due to several factors: the patient's embarrassment regarding the method of obtaining the specimen, parent's concerns of misuse of the specimen, and the issue of obtaining informed consent. As medicine advances and assisted reproduction technology progresses, these issues will need to be addressed.

Making physicians more cognizant of these issues and teaching healthcare professionals how to deal with them is paramount. In this regard, one must mention the pilot program for fertility preservation at Children's Hospital of Philadelphia. Gingsberg et al. describe in the protocol set up at their hospital for discussing such issues in a timely manner and parent's response to the protocol. While most facilities will not have the resources to have this type of multidisciplinary team in place, it is not unreasonable for an institution, department, or practice to have a protocol available for just such an event.

Source: www.medicalnewstoday.com

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Wednesday, June 2, 2010

Testicular Torsion And Infertility!

Testicular Torsion

Testicular torsion has been estimated to affect 1 in every 4 000 males younger than the age of 25 years and has peaks of incidence occurring in the neonate and the adolescent entering puberty.

Inside the scrotum, the testicles are protected on either side by a structure called as spermatic cord. But, sometimes spermatic cord gets twisted around a testicle thus stopping the blood supply to that testicle.

The cause of testicular torsion is still not known, but it can result from any serious injury to the testicles or by doing any strenuous activity. Sometimes, there is no apparent reason for this condition. The condition is more common in infant boys and boys who are going through puberty.

Effects of testicular torsion:

The condition causes sudden and severe pain, enlargement of the affected testicles, swelling and tenderness.

Your testicle may seem swollen or may look like it is higher in the scrotum than the other testicle. You may also experience vomiting, nausea, blood in the semen and dizziness.

Is there any treatment for testicular torsion?

The condition needs immediate medical attention. Surgery called as orchiopexy is the treatment for correcting testicular torsion. The functioning of the testicle can be saved if the condition is diagnosed and corrected immediately.

If the testicle is restricted from the blood supply for a long time, the testicle can become permanently damaged and may need to be removed.

If you experience any pain in the scrotum, immediately consult your doctor. Because any damage to the testicle can cause fertility problems and sometimes lead to infertility.

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Neonatal Extravaginal Testicular Torsion

Testicular Torsion

It is important to realize that there are two types of testicular torsion.

The type that is most common and usually seen in older children is the intravaginal torsion: This type occurs within the tunica vaginalis. Intravaginal torsion is related to an anomalous testicular suspension that has been referred to as the bell-clapper anomaly. In many instances, this anomaly may be bilateral.

The type that occurs in the neonatal age group is the so called extravaginal torsion. It most commonly develops prenatally in the spermatic cord, proximal to the attachments of the tunica vaginalis. It occurs when the testes may freely rotate prior to the development of testicular fixation via the tunica vaginalis within the scrotum.

The extravaginal torsion comprises approximately 5% of all torsions. and is often associated with a high birth weight.

Up to 20% of cases are bilateral. Bilateral neonatal torsion can occur at the same time or at different times in utero. The latter can result in a different aspect of the testes at the time of examination.

Torsion of the spermatic cord may interrupt blood flow to the testis and epididymis. The degree of torsion may vary. The extent and duration of the torsion influence both the immediate salvage rate and late testicular atrophy. Testicular salvage most likely occurs if the duration of torsion is less than 6-8 hours. After 24 hours testicular necrosis develops in most patients.

In the case of a neonatal testicular torsion because of the long time between the onset of the torsion and the moment of examination there are nearly always necrotic changes in the involved testis.

Prenatal torsion manifests as a firm, hard, scrotal mass, and is usually asymptomatic. The scrotal skin characteristically fixes to the necrotic gonad.

Traubici et al describe in their article Testicular Torsion in Neonates and Infants: Sonographic Features in 30 Patients in the American journal of radiology 3 types

Type 1.—In type 1 there was marked enlargement with heterogeneity in echogenicity of the affected testicle. No detectable Doppler flow could be detected in the testicle. In a few patients, linear hypoechoic striations were seen, oriented radially from the mediastinum testis A hydrocele occasionally with debris was present with thickening of the surrounding soft tissues (A simple hydrocele was seen in the contralateral scrotum in a few patients.

Type 2.— In these patients, the size of the testicle was normal and symmetric with the uninvolved testicle, the echogenicity was heterogeneous. In a number of patients, peripheral hyperechogenicity was seen. A small hydrocele was present in several patients.

Type 3.—In the third group of patients the testicle was markedly diminished with only a small amount of testicular tissue persisting. Areas of increased echogenicity were seen scattered throughout the testicle. A hydrocele was not observed in these patients.

The different patterns represent stages in the evolution of the process of ischemic necrosis.

In the presented case the testis is small with slight peripheral hyperechogenicity and no hydrocele consistent with a type 2 to 3.

Source: sonoworld.com

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Tuesday, July 21, 2009

Self-Checking Testicular Cancer (Testicular Torsion)

Testicular torsion

Check your testicles monthly in the following manner:

  • do the self-examination lying in a warm bath or while having a long shower, as this softens the skin of the scrotum (skin sac that holds the testicles), which makes it easier to feel the testicles inside.
  • examine the scrotum, looking for any lumps on the skin or swellings inside.
    cradle the whole scrotum and testicles in the palm of your hand and feel the difference between the testicles. One is almost always larger and lying lower. This is completely normal.
  • examine each testicle in turn, and then compare them with each other. Use both hands and gently roll each testicle between thumb and forefinger.
  • Check for any lumps or swellings as both testicles should be smooth except where the duct that carries sperm to the penis, the epididymis, runs. This lies along the top and back of the testicle and normally feels bumpy.
  • Testicular cancer represents only 1 per cent of all cancers in men, but it is the single biggest cause of cancer-related deaths in men aged 15 to 35 years in the UK.

Currently, about 1500 men a year (around 1 in 400) develop the disease in the UK. Unfortunately, the number of UK cases has trebled in the past 25 years and is still rising.

Although testicular cancer is rare, it is not at all uncommon to find a lump in your testicles. There are many conditions that can be easily confused with testicular cancer, and most of them are not anything like as serious.

Source: www.netdoctor.co.uk

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Wednesday, July 15, 2009

Testicular Torsion Ultrasound (Testicular Torsion)

Testicular Torsion
Ultrasound is helpful to differentiate testicular torsion from other causes of acute scrotal pain and to identify testicular torsion promptly, ensuring the highest salvage rate. The severity of torsion of the testis can range from 180˚ to 720˚, but complete occlusion of blood flow does not occur until 450˚ of torsion. Transient or intermittent torsion with spontaneous resolution sometimes occurs. Venous congestion progresses to arterial occlusion, testicular ischemia, and infarction. The collateral blood flow is typically not adequate to provide viability to the testicle if the testicular artery is occluded.

Testicular torsion can be classified as extravaginal or intravaginal. Extravaginal torsion occurs in utero or perinatally before the testis is fixed, so the torsion occurs proximal to attachment of the tunica vaginalis, in the inguinal canal or just below it. This form of torsion is found exclusively in newborn infants. Intravaginal torsion is more common and is due to a bell-and-clapper deformity in which the tunica vaginalis has an abnormally high insertion on the spermatic cord and completely encircles the testis, leaving the testis free to rotate within the tunica vaginalis. The deformity is bilateral in most cases. Intravaginal torsion may also occur in testes that are retractile or are not fully descended. Blunt trauma, sudden forceful rotation of the body, or sudden exertion also predispose to testicular torsion.
Testicular Torsion

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Monday, July 6, 2009

Testicular Torsion Surgery (Testicular Torsion)

Testicular Torsion

In testicular torsion the spermatic cord that provides the blood supply to a testicleis 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. Death of the testicle can occur in a few hours. Once the testicle is dead it must be removed to prevent gangrenous 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 urethritisor urinary tract infectionto be made. A doppler ultrasound scanof the scrotum, if available, is of immense help in the diagnosis by showing the presence or absence of blood flow to the testicle. Dizziness and nausea are often present when there is an absence of blood supply to the testicle. If the diagnosis is questionable, an expert should be consulted immediately, because testicular viability may be compromised. If physical examination suggests a compromised blood supply and the patient has had such symptoms for a significant period of time, medical personnel may choose to bring the patient directly to surgery without an ultrasound since the time required for ultrasound testing could affect testicular viability. With prompt diagnosis and treatment the testicle can be saved in a high number of cases (see references below).

A simple surgery will correct and prevent testicular torsion. It can be done in an emergency situation after determination that the testicle is cut off from blood supply or as an outpatient procedure for patients who have experienced frequent episodes with testicular torsion. If necessary, the surgeon will first untwist the testicle(s). The surgeon will then permanently suture the testicles to the inner lining of the scrotum. If only one testicle has been problematic, the surgeon will still suture both testicles as a preventative effort.

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Wednesday, June 24, 2009

Testicular Self Examination (Testicular Torsion)

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The Testicular Cancer Resource Center (TCRC) recommends following these steps every month (keep in mind that the point is not to find something wrong, it is to learn what everything feels like so that you will know if something changes):

  • Stand in front of a mirror. Check for any swelling on the scrotal skin.
  • Examine each testicle with both hands. Place the index and middle fingers under the testicle with the thumbs placed on top. Roll the testicle gently between the thumbs and fingers -- you shouldn't feel any pain when doing the exam. Don't be alarmed if one testicle seems slightly larger than the other, that's normal.
  • Find the epididymis, the soft, tubelike structure behind the testicle that collects and carries sperm. If you are familiar with this structure, you won't mistake it for a suspicious lump.
  • Cancerous lumps usually are found on the sides of the testicle but can also show up on the front. Lumps on the epididymis are not cancerous.
  • If you find a lump on your testicle, see a doctor, preferably a urologist, right away. The abnormality may not be cancer, it may just be an infection. But if it is testicular cancer, it will spread if it is not stopped by treatment. Waiting and hoping will not fix anything.
  • Please note that free floating lumps in the scrotum that are not attached in any way to a testicle are not testicular cancer. When in doubt, get it checked out - if only for peace of mind!

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Sunday, June 21, 2009

Acute Testicular Torsion In Children (Testicular Torsion)

Testicular Torsion

Acute testicular torsion in children is an emergency and has to be diagnosed urgently. Doppler sonography is increasingly used in imaging the acute scrotum. Nevertheless, in uncertain cases, surgical exploration is required. In this study, we attempted to define the role of Doppler sonography in the diagnostic workup of the acutely painful scrotum. All patients admitted between 1999 and 2005 with acute scrotal pain were included. After clinical assessment, patients were imaged by Doppler sonography with a ''high-end'' instrument. In cases of absent arterial perfusion of the testis in Doppler sonography, surgical exploration was carried out. Patients with unaffected perfusion were followed clinically by ultrasound for up to 2 years. Sixty-one infants and children aged 1 day to 17 years (median: 7.9 years) were included. In 14 cases, sonography demonstrated absent central perfusion, with abnormal parenchymal echogenicity in six. Absence of venous blood flow together with reduction of central arterial perfusion was found in one infant. In these 15 patients, surgical exploration confirmed testicular torsion. Among the other 46 patients, we found four cases with increased testicular perfusion and 27 with increased perfusion of the epididymis. In one infant, a testicular tumour was found sonographically, and orchiectomy confirmed diagnosis of a teratoma. Follow-up examinations of the conservatively treated patients showed good clinical outcome with physiologic central perfusion as well as normal echogenic pattern of both testes. No case of testicular torsion was missed. By means of Doppler sonography, an unequivocal statement regarding testicular perfusion was possible in all cases. The initial Doppler diagnosis was confirmed by operative evaluation and follow-up ultrasound. Testicular torsion can therefore be excluded by correctly performed ultrasound with modern equipment.

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Testicle Pain (Testicular Torsion)

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The acute scrotum presents as testicular pain or swelling. Testicular torsion represents a surgical emergency because the likelihood of testicular salvage diminishes with the duration of torsion. Testicular torsion must be quickly excluded in any patient.

The history and physical examination can significantly narrow the differential diagnosis of an acute scrotum, if not establish the exact cause. None of the conditions responsible for acute scrotal pain or swelling has a single pathognomonic finding, but the combined background information and physical findings frequently suggest the correct diagnosis of testicle pain.

The age of the patient is important. Testicular torsion is most common in neonates and postpubertal boys, although it can occur in males of any age. Schönlein-Henoch purpura and torsion of a testicular appendage typically occur in prepubertal boys, whereas epididymitis most often develops.

The onset and duration of pain must be carefully determined. Testicular torsion usually begins abruptly, as if a switch has been flipped. The pain is severe, and the patient often appears uncomfortable. Moderate pain developing gradually over a few days is more suggestive of epididymitis or appendiceal torsion. With either of these conditions, the patient may appear relatively comfortable.

The physician needs to be aware that an embarrassed child may state that he has lower abdominal or inguinal pain rather than scrotal.

A history of trauma does not exclude the diagnosis of testicular torsion. Scrotal trauma incurred during sports activities or rough, boisterous play often causes severe pain of short duration. Pain that persists for more than one hour after scrotal trauma.

Information should always be obtained about prior occurrence of pain. When asked, many patients with torsion.

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Saturday, June 20, 2009

Testicular Torsion: The Risk Factors

Testicular Torsion

In most males, the testicles are attached to the inner lining of the scrotum. Males whose attachment is higher up are at risk of testicular torsion. This condition is known as a bell clapper deformity (as in the central piece of a bell) and is a major cause of testicular torsion. A male who notices the ability of either or both testicles to freely rotate within the scrotum should be aware that he is at risk of testicular torsion. Testicles that are in a much lower position and/or in a slightly rotated position in the scrotal sack are a visual indicator of this risk.

Torsions are sometimes called "winter syndrome". This is because they often happen in winter, when it is cold outside. The scrotum of a man who has been lying in a warm bed is relaxed. When he arises, his scrotum is exposed to the colder room air. If the spermatic cord is twisted while the scrotum is loose, the sudden contraction that results from the abrupt temperature change can trap the testicle in that position. The result is a testicular torsion.

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Causes of Testicular Torsion (Testicular Torsion)

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* Neurogenic Disorders (spinal cord and brain injuries, nerve disorders such as Parkinson's disease, Alzheimer's disease, multiple sclerosis, and stroke.)
* Hormonal Disorders (pituitary gland tumor; low level of the hormone testosterone).
* Arterial Disorders (peripheral vascular disease, hypertension; reduced blood flow to the penis). * Cavernosal Disorders (Peyronie's disease)
* Nonphysical causes: Mental disorders (clinical depression, schizophrenia, substance abuse, panic disorder, generalized anxiety disorder, personality disorders or traits.), psychological problems, negative feelings.
* Surgery (radiation therapy, surgery of the colon, prostate, bladder, or rectum may damage the nerves and blood vessels involved in erection. Prostate and bladder cancer surgery often require removing tissue and nerves surrounding a tumor, which increases the risk for impotence.)
* Ageing.
* Lifestyle: alcohol and drugs, obesity, cigarette smoking (Incidence of impotence is approximately 85 percent higher in male smokers compared to non-smokers. Smoking is a key cause of erectile dysfunction. Smoking causes impotence because it promotes arterial narrowing.)
* Other disorders.

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Friday, June 19, 2009

Symptoms Of Testicular Torsion (Testicular Torsion)

Testicular Torsion

Most parents know that certain symptoms can be associated with serious conditions in their children. The most common ones are as follows:

  • Stiff neck may mean meningitis
  • Abdominal pain may mean appendicitis
  • Bad cough may mean pneumonia
Testicular torsion is an uncommon condition that most parents have never heard of; however, as with the problems noted above, it is important to get urgent medical attention for the condition. Although testicular torsion can occur at any age, it is most common in 12- to 18-year-olds.


In order to prevent the testicles from twisting, they are anchored it to the side of the scrotum. Sometimes, this attachment is in the wrong place, which allows the testicle to twist 360 degrees. If this happens, the artery that supplies blood to the testicle will twist as well thereby cutting off its blood supply. Shortly after this occurs, a child will experience pain and swelling because the testicle is being deprived of oxygen. Although this is not a life-threatening condition, the testicle itself may die if the problem is not diagnosed and treated within six to eight hours.

Although doctors know about the importance of diagnosing and treating testicular torsion as soon as possible, most parents do not. Also, since adolescents may be reluctant to discuss genital symptoms with their parents, further delays can occur before a diagnosis is made. You can remedy this situation by asking your doctor to discuss the problem at your child's next checkup. If a teenager knows that testicular pain is an emergency, he will hopefully be more proactive reporting the problem to his parents.

By: Howard J. Bennett, M.D.

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Thursday, June 18, 2009

Testicular Torsion Repair (Testicular Torsion)

Testicular torsion

Testicular torsion repair is surgery to untangle the twisted spermatic cord that is causing testicular torsion.

Testicular torsion repair surgery is usually done under general anesthesia (asleep, no pain). A cut is made in the scrotum, and the testicle is uncoiled. Stitches are used to secure the testicle to the inside of the scrotum. The other unaffected testicle is also secured, because it is at increased risk for torsion at a later date.

Testicular torsion is an emergency. Surgery is usually needed right away to relieve the sudden severe pain and swelling and to prevent the loss of the testicle. For the best results, it should be performed within 6 hours after symptoms begin. By 12 hours, a testicle may become damaged so badly that it has to be removed.

Risks for any anesthesia are:

- Breathing problems
- Allergic reactions to medicines

Risks for any surgery are:

- Bleeding
- Infection

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Wednesday, June 17, 2009

Testicular Torsion: A fatal disorder of the testicles

Testicular Torsion

Testicular Torsion refers to the emergency surgical need for the person affected by the testicular disorder.

This testicular disorder is one of the most fatal of health disorders and if not treated in due time, the disorder may actually result in the literal loss of the affected testicle.

This highly painful testicular problem arises when the spermatic chord gets twisted and as a result the testicles fail to receive an adequate supply of blood. And when the testicle tissues fail to get the adequate amount of blood, they slowly begin to die.

In case of the testicular torsion the testicle that is affected gets severely damaged, the longer the torsion, the severe the damage. This is the reason why, this testicular disorder needs to be treated in time.

This kind of disorder occurs commonly among boys and men between the age group of 12-18 that is when they are in their adolescence to adult phase. The testicular torsion usually occurs in one testicle. But this not mean that it cannot occur on the both sides of the scrotum, in fact of all the testicular torsion cases, 40 % of the patients have problems with both their testicles.

Generally, this problem of the testicular torsion is triggered an “anatomic anamoly” , which in the medical terms is known as the “bell clapper deformity”.It is due to this anatomic or the bell clapper deformity the the spermatic chord gets twisted thereby diminishing the blood flow into the testicles.

This deformity that leads to the torsion is said to be caused by traumatic cases and could also be the result of unprompted occurrences health problems.

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Testicular Torsion Treatment (Testicular Torsion)

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With prompt diagnosis and treatment the testicle can be saved in a high number of cases.

Testicular torsion is a medical emergency that needs immediate treatment. If treated within 6 hours, there is nearly a 100% chance of saving the testicle. Within 12 hours this rate decreases to 70%, within 24 hours is 20%, and after 24 hours the rate approaches 0. (eMedicineHealth) Once the testicle is dead it must be removed to prevent gangrenous infection.

A simple and minimally invasive surgery pioneered in Dallas by Dr. Dean Moheet in 1952 effectively corrects and further prevents future testicular torsion. It can be done in an emergency situation after determination that the testicle is cut off from blood supply or as an outpatient procedure for patients who have experienced frequent episodes with testicular torsion. If necessary, the surgeon will first untwist the testicle(s). The surgeon will then permanently suture the testicles to the inner lining of the scrotum. If only one testicle has been problematic, the surgeon may suture both testicles as a preventative effort.

In some cases the testicle can untwist on its own or it can also be manually untwisted, which can be attempted with pain relief as the guide for successful detorsion. Manual detorsion is successful in 26.5% to greater than 80% of patients based upon a number of reviewed studies.

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Tuesday, June 16, 2009

Testicular Torsion Overview (Testicular torsion)

Testicular torsion

Testicular torsion is a surgical emergency that may result in the loss of the affected testicle if not treated promptly. This is a painful condition caused by the twisting of the spermatic cord, which causes a loss of blood flow to the testicle. Testicular tissue cannot survive without blood flow. Torsion is the most common cause of testicle loss in adolescent males.

In testicular torsion the spermatic cord that provides the blood supply to a testicle is twisted, cutting off the blood supply, often causing orchialgia. Prolonged testicular torsion will result in the death of the testicle and surrounding tissues.

It is also believed that torsion occurring during fetal development can lead to the so-called neonatal torsion or vanishing testis, and is one of the causes of an infant being born with monorchism (one testicle).

Testicular torsion

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