Intermittent Testicular Torsion: Difficult clinical diagnosis

Intermittent Testicular Torsion: Difficult clinical diagnosis
FB Dr Soarawee
Soarawee Weerasopone, MD

Royal Phnom Penh hospital, Kingdom of Cambodia

I have been seeing several cases related to the Intermittent testicular torsion’s patients throughout my practicing in urological.  Patients were always at the emergency room with a severe testicular pain. The pain was extremely bad, so bad to make patient couldn’t do anything besides laid down on the bed and sobbing to get help. First, I’m sure that there’re some Urologists will assume this emergency condition that called a “Testicular torsion” which I was written this article previously.

Intermittent Testicular Torsion: Difficult clinical diagnosis
Patients were always at the emergency room with a severe testicular pain.

Realistically, it is not simply as in the textbook. The Classical torsion must show there’s no a sign of “blood supplying” during perform a doppler ultrasonography. What if there still has blood supplying from the imaging showed? How can we tell them what’s going on for the diagnostic?  This is why we need to figure out the Intermittent torsion today.

Intermittent testicular torsion is a state of testis which can release torsion by itself. Once the torsion release, the pain is dramatically gone. Failure to identify this condition can lead to the real testicular torsion which resulting in testicular loss.

Clinical suspicious on intermittent testicular torsion

  1. A sudden onset of testicular painful
  2. Very severely on testicular painful
  3. Always complain at one side of the testicular: most of it is on the left side
  4. The pain usually interfered right to the groin area
  5. The pain should be gone itself just within 1 hour
  6. The pain can be recurred within weeks or a months later
  7. Horizontal lie of testis during torsion period is a classical physical examination sign

Imaging on Intermittent testicular torsion

  • Normal testicular blood supplying from doppler ultrasound will be reported
Intermittent Testicular Torsion: Difficult clinical diagnosis
It is recommended to do testicular fixation operation or Orchiopexy.

Once Intermittent testicular torsion is being suspected, that would be recommended to do the operation called “Orchiopexy” or testicular fixation operation to avoid recurrent testicular torsion in the future. Any questions, talk to your trusted urologist, or it would be my honor if you text me. Take care!

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