What artery is affected in testicular torsion?
Pathophysiology. Testicular torsion occurs when there is mechanical twisting of the spermatic cord, which suspends the testicle within the scrotum and contains the testicular artery and vein. Twisting of the cord reduces or eliminates blood flow to the testicle.
Is Cremasteric reflex present in testicular torsion?
The absence of the reflex is considered to be diagnostic for testicular torsion. The cremasteric reflex has been reported to be absent in 100% of cases of testicular torsion, making it a potentially useful sign in this diagnosis.
What structures are involved in testicular torsion?
Testicular torsion is caused by twisting of the spermatic cord and the blood supply to the testicle (see the image below). With mature attachments, the tunica vaginalis is attached securely to the posterior lateral aspect of the testicle, and, within it, the spermatic cord is not very mobile.
In what age groups are these types of testicular torsion most common?
Testicular torsion occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum. The reduced blood flow causes sudden and often severe pain and swelling. Testicular torsion is most common between ages 12 and 18, but it can occur at any age, even before birth.
What is the testicular artery?
The testicular arteries (also known as the spermatic arteries) are the long, small-diameter gonadal arteries in the male that supply the testis alongside the cremasteric artery and the artery to the ductus deferens.
How do you test for Cremasteric reflex?
The cremasteric reflex is elicited in males by stroking the inner aspects of the thigh in a caudal–rostral direction and observing the contraction of the scrotum.
Which nerve is responsible for cremasteric reflex?
The innervation for the cremasteric reflex is provided by the sensory and motor fibers of the genitofemoral nerve that originates from the L1 and L2 spinal nerve nuclei. Stroking of the inner thigh stimulates the sensory fibers of the genitofemoral and ilioinguinal nerves.
What is testicular appendage?
The appendix testis is a small appendage of normal tissue that is usually located on the upper portion of the testis. The appendix epididymis is a small appendage on the top of the epididymis (a tube-shaped structure connected to the testicle). Torsion of an appendage occurs when this tissue twists.
What is the surgical procedure for testicular torsion?
Surgical repair, or orchiopexy, is usually required to treat testicular torsion. In rare cases, your doctor may be able to untwist the spermatic cord by hand. This procedure is called “manual detorsion.” Surgery is performed as quickly as possible to restore blood flow to the testicles.
How do you treat testicular torsion?
How Is Testicular Torsion Treated? Testicular torsion almost always requires surgery to correct. In rare cases, the doctor might be able to untwist the spermatic cord by pushing on the scrotum, but most guys will still need surgery to attach both testicles to the scrotum to prevent torsion from happening in the future.
What does the phrenic artery supply?
Function. The inferior phrenic arteries supply the diaphragm. Each of the smaller vessels give off superior suprarenal branches to the suprarenal gland of its own side. The spleen and the liver also receive a few twigs from the left and right vessels respectively.
What is the role of the cremasteric reflex in testicular torsion?
The cremasteric reflex is almost always absent or diminished on the affected side in patients with testicular torsion, and its presence may help to distinguish other causes of acute scrotal pain from testicular torsion. Case reports, however, have noted the opposite to be true.
What is pediatric testicular torsion?
Pediatric testicular torsion is an acute vascular event in which the spermatic cord becomes twisted on its axis, so that the blood flow to or from the testicle becomes impeded.This results in ischemic injury and infarction. The condition may result in loss of the testis.
What is the difference between the testicular artery and cremasteric artery?
The testicular artery is the principal artery, arising from the aorta, just below the renal artery. The cremasteric artery is a branch of the inferior epigastric artery. The deferential artery is a branch of the superior vesical artery.
What are the signs and symptoms of intravaginal testicular torsion?
Author: Oreoluwa I Ogunyemi, MD; Chief Editor: Edward David Kim, MD, FACS more… Intravaginal testicular torsion produces a sudden onset of severe unilateral scrotal pain followed by inguinal and/or scrotal swelling. Pain may lessen as the necrosis becomes more complete. Gradual onset of pain is an uncommon presentation.