What is the testicular appendage?

Regarding male testicular diseases, most of the time they are congenital diseases, so parents should pay special attention to whether the surrounding areas of their male baby's testicles are different from normal testicles. For example, cryptorchidism is a congenital disease that can only be cured through cryptorchidism surgery to make the testicles appear normal. Testicular appendages are also a congenital disease that often occurs in children. Parents must understand the relevant knowledge about testicular appendages.

The testicular appendages are the degenerated remnants of the upper end of the Müllerian duct. Located above the testicle, it is a small oval body with a pedicle, often attached to the white membrane of the testicle, and is smaller than a mung bean. The appendages of the epididymis are the remnants of the medullary duct.

Testicular appendage torsion is more common in children. The appendages of the epididymis are the remnants of the medullary duct.

diagnosis

History of testicular appendage torsion

The onset is generally mild and gradually worsens within one or two days; however, there may also be acute attacks with severe pain.

Symptoms of testicular torsion

It manifests as sudden pain in the scrotum. It is usually a dull pain, but may also be colic. The degree of pain varies. The pain may radiate to the lower abdomen. May be accompanied by systemic symptoms such as nausea and vomiting.

Testicular appendage torsion physical examination

A lump may be found above the testicle, accompanied by mild tenderness. A small amount of reactive hydrocele may be detected. If necrosis occurs, the effusion will appear blue during the transillumination test and the adnexa may be palpable above the testicle. The position of the testicles and spermatic cord is normal.

Differential diagnosis of testicular appendage torsion

The diseases that need to be differentiated from testicular appendage torsion are roughly the same as testicular torsion, and the following points should be noted.

Testicular appendage torsion Testicular torsion

There is often a history of strenuous exercise and scrotal injury, accompanied by severe nausea, vomiting, and severe scrotal pain. During examination, it can be seen that the testicles have moved upward, and moving the testicles can aggravate the pain. Doppler ultrasonography showed no blood in the testicles.

Testicular appendage torsion Acute epididymitis

It is an acute inflammation of the epididymis, which develops rapidly and may be accompanied by severe systemic symptoms, such as fever and increased white blood cell count. During the examination, it was found that the scrotum was obviously enlarged and the skin was red; the epididymis was obviously enlarged and the boundary with the testicle was unclear. The tenderness is obvious. Generally, questions can be asked about the history of unclean sexual intercourse, history of transurethral instrument monitoring, etc.

Testicular appendage torsion treatment

(1) Symptoms can be relieved by supporting the scrotum, resting in bed, and taking oral non-hormonal anti-inflammatory drugs.

(2) When the diagnosis cannot be made, spermatic cord torsion should be excluded and surgical exploration should be performed if necessary.