Testicular torsion

From Dog
testicular torsion in a dog with Sertoli cell tumor[1]

Testicular torsion is a rare pathological disorder of the male testis characterized by mechanical torsion of the spermatic cord and consequent testicular necrosis and infertility.

Mechanical torsion usually results in constriction of blood flow to the affected testis, with concomitant edema and venous congestion[2]. Long term ischemia (>6 hours) usually results in azoospermia and permanent testicular atrophy[3].

In dogs, this is commonly associated with:

A retained testis is more susceptible than a scrotal testis to spermatic cord torsion, and the risk of this condition is increased even more with progressive enlargement of the neoplastic organ[6]. Although closely linked to one another in dogs, concomitant association of cryptorchidism, Sertoli cell tumors, feminizing syndrome and spermatic cord torsion has been rarely reported in the literature[7][8].

Clinically affected dogs usually present with acute testicular and inguinal pain. The testis is often enlarged and tender. Dogs are frequently anorectic and display locomotory difficulty.

Diagnosis is based on historical findings, clinical signs and supportive imaging studies, primarily ultrasonography[9].

A definitive diagnosis usually requires exploratory surgery.

A differential diagnosis would include orchitis or epididymitis due to Rickettsia spp[10] or Brucella spp.

Bilateral or unilateral orchidectomy is usually curative in dogs.

References

  1. Quartuccio M et al (2012) Sertoli cell tumors associated with feminizing syndrome and spermatic cord torsion in two cryptorchid dogs. J Vet Sci 13(2):207-209
  2. Tarhan F et al (2000) Effects of unilateral testicular torsion on the blood flow of contralateral testis - an experimental study on dogs. Scand J Urol Nephrol 34(4):229-232
  3. Kallerhoff M et al (1996) The influence of temperature on changes in pH, lactate and morphology during testicular ischaemia. Br J Urol 78(3):440-445
  4. Hecht S et al (2004) Ultrasound diagnosis: intra-abdominal torsion of a non-neoplastic testicle in a cryptorchid dog. Vet Radiol Ultrasound 45(1):58-61
  5. Mostachio GQ et al (2006) Intraabdominal torsion of a neoplastic testicle and prostatic cyst in a cryptorchid dog. Schweiz Arch Tierheilkd 149(9):408-412
  6. Feldman EC & Nelson RW (187) Canine and Feline Endocrinology and Reproduction. 2nd ed. Philadelphia: Saunders. pp:481–523
  7. Laing EJ et al (1983) Spermatic cord torsion and Sertoli cell tumor in a dog. J Am Vet Med Assoc 183:879–881
  8. Pearson H & Kelly DF (1975) Testicular torsion in the dog: a review of 13 cases. Vet Rec 97:200–204
  9. Brown JM et al (1997) Contrast-enhanced ultrasonographic visualization of gonadal torsion. J Ultrasound Med 16(5):309-316
  10. Ober CP et al (2004) Orchitis in two dogs with Rocky Mountain spotted fever. Vet Radiol Ultrasound 45(5):458-465