Stages of Disease (Torsion of the Testis)

skro_6a_n.jpg to skro_6c_n.jpg: Operative findings in different stages of torsion of the testis according to an increasing time between onset of torsion and revision. skro_6a_n.jpg: Teenager. Testis and epididymis are swollen with bluish spots of the testis. The spermatic cord is twisted. With a therapeutical torsion of the testis to the right side in the picture by 180 the torsion is probably relieved, which occurrred by 180 in a counter-clock direction. In this case surgery was performed on time because the testis does not seem to be damaged irrevocably. skro_6b_n.jpg: 16.7-year-old teenager. The testis is still entirely dark-blue to black although the testis has been untwisted in a counter-clockwise direction up to residual 180 of torsion (the torsion occurred in a clockwise direction by more than 360). The torsion is probably relieved by an additional therapeutic torsion of 180 in a counter-clockwise direction. The testis is probably irrevocably damaged. skro_6c_n.jpg: In this case a macroscopically irrevocable ischemia of the testis is present. The sequels of the torsion do not even permit to describe the degree of of torsion. skro_6a_n.jpg to skro_6c_n.jpg: The operative findings clearly illustrate that the duration of torsion and its degree is critical for the extent of testicular damage. In case of duration of more than 4 hours and of degree of torsion of 360 and more, a loss of the testis must be expected. Therefore, it makes no sense to prolong the time of emergency revision by time-consuming additional examinations in supsected torsion of the testis.