Pathogenesis (development of disease)
The occurrence of testicular torsion is probably due to contraction of the cremaster muscle. Furthermore, by the absence of the gubernaculum testis (ligamentous structure that serves as a guide structure for the testis during its descent into the scrotum (descensus testis)), which inhibits the mobility of the testis. There is mainly venous congestion with severe swelling.
The right testis usually rotates clockwise, the left counterclockwise. The torsion is usually medial (“oriented toward the center of the body”): about 66% (2/3) of cases.
Classification of testicular torsion: one can distinguish the extra- (supra-) from the intravaginal form, extravaginal usually occurring in infants, intravaginal more in adolescents up to 20 years of age. Furthermore, there is testicular torsion against epididymis in testicular epididymal dissociation (from Latin dissociare “to separate”).
Predisposing factors are:
- Cold weather – “winter syndrome” (change from warm to cold).
- Local cold
- Testicular trauma
Etiology (causes)
Biographical causes
- Developmental anomaly – absence of the gubernaculum.
Disease-related causes
Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99).
- Retinate testes/testes that descend (descend) late.
