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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]
An inguinal hernia or groin hernia is a hernia (protrusion) of abdominal cavity contents through the inguinal canal. Symptoms, which may include pain or discomfort especially with or following coughing, exercise, or bowel movements , are absent in about a third of patients.
Testicular torsion may result in irreversible damage to the testicle within hours. A collection of serous fluid in the spermatic cord is named 'funiculocele'. The contents of the abdominal cavity may protrude into the inguinal canal, producing an indirect inguinal hernia. Varicose veins of the spermatic cord are referred to as varicocele ...
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.
Therefore, testicular torsion is a surgical emergency and the role of ultrasound is to differentiate it from epididymitis as both disease presents with acute testicular pain clinically. [citation needed] There are two types of testicular torsion: extravaginal and intravaginal. Extravaginal torsion occurs exclusively in newborns.
Conditions that may result in similar symptoms include testicular torsion, inguinal hernia, and testicular cancer. [1] Ultrasound can be useful if the diagnosis is unclear. [1] Treatment may include pain medications, NSAIDs, and elevation. [1] Recommended antibiotics in those who are young and sexually active are ceftriaxone and doxycycline. [1]
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.
Testicular torsion is also more likely in retained testicles. Surgical correction is by palpation of the retained testicle and subsequent exploration of the inguinal canal or abdomen, but showing altered dogs is against AKC rules, making this correction pointless for breeding stock.