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Testicular torsion may also be caused by trauma to the scrotum or exercise (in particular, bicycle riding); [10] however, only about 4–8% of cases are the result of trauma. [1] [2] There is thought to be a possible genetic basis for predisposition to torsion, based on multiple published reports of familial testicular torsion. [10]
According to Prehn's sign, the physical lifting of the testicles relieves the pain of epididymitis but not pain caused by testicular torsion. [ 4 ] Negative Prehn's sign indicates no pain relief with lifting the affected testicle, which points towards testicular torsion which is a surgical emergency and must be relieved within 6 hours.
The differential diagnosis of testicular pain is broad and involves conditions from benign to life-threatening. The most common causes of pain in children presenting to the emergency room are testicular torsion (16%), torsion of a testicular appendage (46%), and epididymitis (35%). [4] In adults, the most common cause is epididymitis. [citation ...
Testicular conditions: Pain may radiate to the lower abdomen in cases of testicular torsion, epididymitis, or orchitis. Epididymitis is inflammation of the epididymis, a tube at the back of the ...
The cremasteric reflex (elevation of the testicle in response to stroking the upper inner thigh) remains normal. [1] This is a useful sign to distinguish it from testicular torsion. If there is pain relieved by elevation of the testicle, this is called Prehn's sign, which is, however, non-specific and is not useful for diagnosis. [13]
The cremasteric reflex may be absent with testicular torsion, upper and lower motor neuron disorders, as well as a spine injury of L1-L2. It can also occur if the ilioinguinal nerve has accidentally been cut during a hernia repair. [4] The cremasteric reflex can be helpful in recognizing testicular emergencies.
[4] [2] In males, the phenomenon results in an uncomfortable testicular sensation. [5] It most often describes a temporary fluid congestion in the testicles or vulva, caused by prolonged sexual arousal without orgasm. [6] [7] The term epididymal hypertension is derived from the epididymis, a part of the male reproductive system. [8]
Orchiopexy is performed in the event of testicular torsion, a urologic emergency presenting with intense pain and often without inciting injury. [citation needed]While neonatal torsion occurs with no anatomic defect to account for its occurrence (occurring in utero or shortly after birth), adult torsion results from a bilateral congenital anomaly often called a "bell-clapper deformity", where ...