Is there some kind of examination that can be done


Q: Is there some kind of examination that can be done to see if a male has the "bell clapper deformity"? I know it increases the chances of testicular torsion. I figure that the testicles of a male with that deformity look the same as normal testes from the outside, so would an ultrasound be able to discover it?


A:   Hi.
Thanks for your query albeit short and specific.
This can be detected by the typical presentation at the clinical examination wherein the normal placement of the epididymis is not present, it appears more horizontal. A palpating fingers of experienced General Surgeon or Urologist can give the clue.
This can further be confirmed by high resolution ultrasound and color doppler examination.
This is aided by the past or present history of recurrent scrotal pain which vanishes suddenly.

It takes all these three things to determine whether one has clapper bell deformity or not.
I hope this answers your query, please feel free to ask for further relevant queries if you feel that there is a gap of communication or if you want to give any feedback on any of the above mentioned points.

Comments / Follow Ups

Patient: If the recurrent scrotal pain is caused by a milder torsion, is it possible that a major problem won't really occur down the road? In case of full blown torsion, I've heard that it's usually best to twist towards the leg of the affected testicle (so for example left testicle towards left leg) in order to attempt manually untwisting it. Does that sound right?
Doctor: You are theoretically correct to a certain extent as the recurrent attack can cause adhesion and fibrosis but this does not guarantee that a major problem may not come.
Twisting in a certain direction as you have mentioned is allowed only if the immediate medical/surgical facility can not be obtained. Immediate surgical exploration, may be after a color doppler is the only certain way to get a relief, cure and avoidance of recurrence.
Patient: Is the mild form of torsion (that resolves on its own) quite painful as the more serious form? If someone has the bell clapper deformity but has not experienced full blown torsion, would you recommend surgery to correct the deformity in order to reduce chances of torsion?
Doctor: Pain is a subjective phenomenon, but will be severe in both the conditions.
Surgery is highly recommended to correct the deformity and fix the testis to avoid the torsion from happening
This is second and last allowable follow up per query, please ask a fresh, new query if you want further interaction or give feedback. Give reference ID: 506876

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