ABSTRACT
Testicular torsion can occur at any age but is the most common cause of the acute scrotum in the postpubertal period. The twist in adolescents is within an abnormally high insertion of the tunica vaginalis. Such testicles often have a horizontal lie when not torted. Most testicular tumours present with gradually increasing size of the testicle, lump in the testicle, sometimes discomfort and, in around 10%, an associated hydrocele. Some tumours are hormonally active such as the Leydig cell tumour, which produces testosterone, leading to precocious puberty. The standard approach to testicular tumours is via an inguinal incision. The external oblique is opened and the cord mobilised and clamped. If the diagnosis is yolk sac tumour the vessels are divided and the testis removed. For encapsulated teratomas and other tumours such as Leydig cell tumours testis-sparing surgery can be performed.
