Talk:Testicular torsion

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 26 November 2018 and 21 December 2018. Further details are available on the course page. Student editor(s): Andresprk, Quinnjkq. Peer reviewers: Poseysfriend, Jjcubs92.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 10:54, 17 January 2022 (UTC)

Once the testicle is dead it must be surgically removed to prevent gangrene infection

I'm very uncomfortable with this statement. First, not all testes are completely and obviously infarcted at exploration. Removing the testes clearly removes all hope of recovery, there and then. Second, there won't be moist or wet gangrene. Both the arterial AND venous blood flow is cut off - the testis mummifies. In fact, that's how you know it's dead clinically - it shrinks in size progressively. Third, in Pubmed, removal for gangrene was not mentioned in 450 citations. I think the sentence should be removed. It doesn't effect the rest of the article. — Preceding unsigned comment added by Mdscottis (talk • contribs) 17:17, 15 September 2012 (UTC)

Epidemiology

Now the article is for the human disorder, only. Could someone, please, add some information about whether it is possible for other mammals to have this condition, also. -- 85.76.73.183 (talk) 23:00, 17 December 2017 (UTC)

You can add a section at the and for "Other animals" if you wish. Doc James (talk · contribs · email) 02:03, 18 December 2017 (UTC)

Proposed changes

As part of the UCSF WikiMed course, we are planning on making the following changes. Any feedback/discussion is appreciated.

• Plan to change some of the words to make it more easily readable.
  • in the “signs and symptoms” section – words like “transversely oriented”, “pyrexia”, and “infarction” may be too complicated for the regular reader.
  • Expand paragraph on risk factor section to make it more easily understandable (e.g. mesorchium).
  • Perhaps add a SHORT description/picture of the normal lining of the testicle, so readers can understand risk factors section better.
• Comparing with epididymitis is appropriate here. However, it needs to be more clearly delineated (remove or move sections re: testicular torsion in the epididymitis paragraph)
• Expand the complication section, and include inflammatory changes that could occur in the contralateral testicle (response to destruction of necrotic tissue and breakdown of blood-testicular barrier in the affected testicle). Source: Kapoor S. Testicular torsion: a race against time. Int J Clin Pract. 2008;62:821–7. [PubMed]
• In the epidemiology section, it should be noted that incidence is high at 1-2 years of age, and then peaks again during adolescence. It can occur at any age but is rare in adults. Could consider moving this section higher up, or at least closer to “risk factors” since these sections are closely related. Source: Molokw CN, Somani BK, Goodman CM. Outcomes of scrotal exploration for acute scrotal pain suspicious of testicular torsion: a consecutive case series of 173 patients. BJU Int. 2011;107(6):990.
• Source #15 is outdated (in terms of epidemiology of testicular torsion).
• Under “Treatment” section – “manual detorsion may correct the problem” can be misleading as patients require surgical exploration regardless of symptomatic relief by manual detorsion. This section should emphasize the importance of surgical exploration (even to prevent recurrence).
• Source 7 is a case report…can this be used? If so, are there any other case reports out there regarding testicular torsion secondary to trauma?
• Plan on doing a literature search for more recently published articles to look for any updated information in the next week.
• Specifically, we will look as cold temperature as a risk factor (this is highly debated and could perhaps be removed from the section) and include more on the timing and progression of testicular torsion.
• New literature suggest that some testicles may be salvaged even past 48 hours. Source: Mellick LB, Sinex JE, Gibson RW, Mears K. A Systematic Review of Testicle Survital Time After a Torsion Event. Pediatr Emerg Care. 2017 Sep 25. [Pubmed]

Andresprk (talk) 04:08, 3 December 2018 (UTC)andresprk Andresprk (talk) 04:08, 3 December 2018 (UTC)Quinnjkq Quinnjkq (talk) 04:12, 3 December 2018 (UTC)QuinnjkqQuinnjkq (talk) 04:12, 3 December 2018 (UTC)

@Andresprk and Quinnjkq: Responding to just three of your bullet points:

• more easily understandable – Yes, making an article more understandable to a general readership, which is Wikipedia's audience, is a good goal. But it depends how you do it; I wouldn't dumb it down by removing words such as mesorchium, which should be (and in this case, is already) hyperlinked in the text. Can you elaborate on exactly what you mean by making it "more easily understandable" and how you plan to do that?
• Usability of case report – Since the source in Note 7 that you are asking about is only being used to support the statement "It may also be caused by trauma; this is fairly rare.", i.e., that it is a possible cause, my guess is you can use it; but check with WP:MEDRS. OTOH, if it can be caused by a whole long list of things, including this, and other (possibly rare) causes, that would make the inclusion of this rare cause a violation of the principle of undue weight. So, there are multiple factors to consider, in whether it is, or isn't, appropriate to include.
• New literature suggests... – be careful on interpreting things from recent primary sources. I am not an experienced medical editor here at WP, but my understanding is that we prefer survey- or review-type medical articles, partly because they are secondary sources. Summarizing what just one, or a few, primary sources say, could be violations of WP:UNDUE or WP:SYNTH.

On these and other points, someone from WikiProject Medicine such as Doc James may want to weigh in on these, or other points of your plan. Thanks for coming to the Talk page to discuss this first; that is the right thing to do. Btw, if you have not already looked at the guidelines on sourcing of medical articles at Wikipedia, please study WP:MEDRS carefully. And good luck in your course! Mathglot (talk) 20:51, 4 December 2018 (UTC)

If you can find high quality secondary sources to replace case reports with, that is always a good idea. Doc James (talk · contribs · email) 16:03, 5 December 2018 (UTC)

Peer Review

Hi Quinnjkg,

You and Andresprk have done some great work with this article! A few overall thoughts and then a tabular listing of criteria that our class agreed on at the start of the course. First, I am impressed by how well-written the article is overall. The lead section is written with language that would be easily understandable to a layperson and while there is more clinical language used deeper in the article the link-outs and in-text explanations are appropriate. Your sources are appropriate, the organization makes sense and I especially like the summary table at the top of the article. I would suggest trying to find anatomical drawings or other illustrations to help readers understand the anatomy discussed in the pathophysiology section (hopefully that lead we discussed in the in-class discussion could be used). Also, I suggest including links for the complications paragraph and considering a prose format for that section to remain consistent with the rest of the article. Overall, a very informative and helpful article!

Header text	Header text
Readability	Lead section is understandable to the lay reader. More technical language used (especially medical and anatomical terms ie tunia vaginalis and epididymitis) but, as above, use of links and in-text explanations are appropriate.
Target Readership	Targeted to lay reader. Use of clinical terms is necessary and I don't think you can avoid them and still maintain an accurate description of the disease process.
Citation quality	Excellent. Most articles cited are review articles with full text available through subscription though a few are free. Is it possible to include a link to the cited chapter in Tintinalli's (source 13)? Also, for source 14 (Lavallee, Cash) is it possible to have the link go to a full article instead of an abstract only? When I look, I find a publisher login page. Not sure if this article can be found in full but the abstract, I feel, is appropriate for the article's usage in your Wikipedia page (radionuclide scintigraphy).
Overall Organization	Appropriate and easy to understand. Suggest considering prose format instead of bullet points for the complications paragraph to maintain consistent formatting.
Pictures and Media	I like the image in the summary table at the top of the page. If possible (and as above), try to include anatomical drawings or images for the pathophysiology section as I believe this could greatly help with comprehension.
Links	Seems appropriate. Suggestions: 1) link out to epididymitis earlier in the page, under 'signs and symptoms' instead of lower down under 'diagnosis' 2) link out to 'necrosis' for usage of the word "necrotic" in the pathophys section 3) link out to 'embryo' for usage of the word "embryonic" in the pathophys section
Avoiding doctor-speak	Language is appropriate, as above.
US-centric idioms	Do not appear to be an issue.
Small grammar/editing suggestions	1) Lead section - "Cold temperatures may also be a risk factor" - suggest saying outright "risk factor of testicular torsion" to avoid ambiguity. 2) Lead section last paragraph - suggest "In children" instead of "of children" 3) Signs/Symptoms - suggest specifying that the normal function of the cremasteric reflex is elevation of the testicle. 4) In 1st paragraph of pathophysiology, "degree of arterial and venous obstruction depends" ON not OF. 5) See also section - "epididymitis - can cause of"

Poseysfriend (talk) 05:39, 17 December 2018 (UTC)

Additional peer review

As noted above, really good job with this article, a lot of good additions, sources, and writing. Much of the article has really good readiblility and avoidance of jargon, especially the signs and symptoms section and treatment, but there are a few places where that could be improved (I am a fan of always looking to improve that). You use many links for the complicated words, which is a great way to use the words and still have someone figure out the meaning, but possibly working to avoid those words in the first place could decrease the amount that someone has to define as they read this article. Words such as cryptorchidisim, technetium-99m pertechnetate, etc. For example, the following sentance: "In this condition, rather than the testes attaching posteriorly to the inner lining of the scrotum by the mesorchium, the mesorchium terminates early and the testis is free floating in the tunica vaginalis." Instead is there a way to describe the bell-clapper deformity by using general terms, describing it as a malformation of a single structure that allows the testis to be free floating within the scrotum as opposed to securely anchoring within the scrotum. Also instead of linking to Prehn's sign, possibly describing what it is (if it is a classic physical finding) in the paragraph could be useful, even if it isn't the most reliable physical exam finding. Overall organization makes it easy to follow, and the content is well sourced. Jjcubs92 (talk) 06:37, 20 December 2018 (UTC)

This page HAS BEEN VANDALIZED!

This page has been vandalized with some nonsense about Scarlet Johansson etc.

I just spent TEN MINUTES looking for an EASY WAY to report vandalism on a page and COULD NOT find an answer.

I suppose all article readers are assumed to be tech savvy enough to FIX the issue themselves?

That’s ABSURD.

Why doesn’t each Wiki page have a SIMPLE way to report vandalism ?

Like a link, or button, or option under “Edit”?

Anyway, I found it, and reported it on this Talk page. Someone please fix it.

Thank you. WB (talk) 22:18, 27 April 2019 (UTC)

Hi WBoutros! Vandalism was reverted just over 2 hours after it occurred. The easiest way to revert vandalism is to click on "View history", find the edit, and click "undo". Thanks! Bibeyjj (talk) 10:00, 20 May 2021 (UTC)

Prevent

Does exist any way to prevent this? Does the pregnant can eat something? Thanks!--186.61.223.54 (talk) 20:09, 4 May 2019 (UTC)

Hi 186.61.223.54! I'm afraid that I don't understand your query about the article. The article already includes content about risk factors. Bibeyjj (talk) 10:00, 20 May 2021 (UTC)