Bovis ISSN 2398-2993

Spermatic cord torsion

Synonym(s): Testicular torsion

Contributor(s): Ash Phipps , Paul Wood

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Introduction

  • Torsion of the spermatic cord occurs as the testicle rotates between 90° and 180° about its longitudinal axis. This compromises the blood flow to the testicle. Complete torsion usually occurs when the testicle rotates greater than 360°.
    • Note: torsions may be permanent or transient.
  • Etiology: unknown.
  • Clinical signs: 
    • Spermatic cord torsions of >180° torsion, the most common clinical sign observed is colic.
    • Spermatic cord torsions of <180° there are often no clinical signs.
  • Diagnosis: diagnosis of the condition can be made on palpation of the testis, ultrasonography of the testis, or exploratory surgery.
  • Treatment: unilateral castration if the torsion is severe enough that the affected testicle is non-viable or if the damage is severe enough to result in degeneration of that or the contralateral testis.
  • Prognosis: dependent on duration and degree of torsion.

Pathogenesis

Etiology

  • Unknown.
  • ≤180° torsion probably develops during testicular descent.
  • Possible factors include elongation of the caudal ligament of the epididymis or proper ligament of the testis and/or excessively long mesorchium. Contraction of the cremaster muscle may initiate rotation which is not inhibited by the increased length of the caudal ligament.

Predisposing factors

General

  • Young bulls.

Pathophysiology

  • Torsion of the spermatic cord usually occurs in descended testes and is commonly unilateral.
  • ≤180° torsion is usually an incidental finding; which is likely to have occurred during testicular descent.
  • ≤180° torsion may occur during testicular descent → tail of epididymis lies cranial to the testis → may be uni- or bilateral → usually no pronounced effect on libido or semen quality. In many permanent cases of ≤180° unilateral spermatic cord torsion the testis is slightly smaller than the unaffected contralateral testis.
  • ≤180° sporadic or permanent bilateral spermatic cord torsions may occur, usually with no significant problems.
  • >180° torsion causes signs of colic.
  • Infarction of the testis follows vascular strangulation of the vessels in the spermatic cord. The thin-walled veins are more likely to be affected than the thick-walled arteries.
  • >180° torsion → severe vascular compromise and venous obstruction leading to hemorrhagic infarctions and localized edema. Arterial occlusion results in ischemic necrosis of all contents distal to torsion. The testis is under pressure, swollen and painful.

Timecourse

  • ≤180° torsions can be permanent or occur intermittently.
  • >180° torsions usually occur acutely.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Gnemmi G & Lefebvre R C (2009) Ultrasound imaging of the bull reproductive tract: an important field of expertise for veterinarians. Veterinary Clinics of North America: Food Animal Practice 25 (3), pp 767-779 PubMed.

Other sources of information

  • McEntee M (2012) Reproductive pathology of domestic mammals. Elsevier. pp 253-254.
  • Blanchard T, Munroe G, Watson, E & Campbell M (2017) Spermatic cord: torsion. [online] Ed: Vetstream Equis, Available at: www.vetstream.com.


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