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What is torsion of the appendix testis?

Torsion of the appendix testis is a twisting of a vestigial appendage that is located along the testicle. This appendage has no function, yet more than half of all boys are born with one.

Although this condition poses no threat to health, it can be painful. Usually no treatment other than to manage pain is needed.

What happens in torsion of the appendix testis?

The appendix testis is a vestigial remnant of the Müllerian duct, from which female reproductive organs form in the embryo. In boys, it has no function, much as the appendix in our abdomen has no function. More than half of all boys are born with an appendix testis, usually with no ill effects. Occasionally, a problem can occur if the appendix testis twists and chokes off its blood supply. Although it involves only a tiny amount of tissue, your son may experience considerable pain.

Symptoms & Causes

What are the symptoms of torsion of the appendix testis?

Symptoms include pain, and sometimes swelling, in the scrotum (the bag of skin hanging behind the penis). The symptoms for this condition are very similar to the symptoms of testicular torsion.

Diagnosis & Treatments

How is torsion of the appendix testis diagnosed?

A pediatric urologist will examine your son and make a diagnosis based on a physical examination and family history. A scrotal ultrasound or an X-ray, or both, are sometimes taken. If there is a lot of swelling or the radiology tests are inconclusive, the urologist may perform exploratory surgery to rule out testicular torsion, which is a medical emergency.

How is torsion of the appendix testis treated?

Once properly diagnosed, no treatment is generally needed, other than observation and measures to relieve pain, such as:

  • Rest
  • Analgesics, such as acetaminophen and ibuprofen
  • An ice pack over the affected area

Once symptoms subside, the problem is unlikely to recur. If the pain persists more than 10 days, your son might need surgery to correct the problem.

How Boston Children's Hospital cares for torsion of the appendix testis

Because torsion of the appendix testis poses no threat to the overall health of your son, treatment is relatively simple. Your physician will make sure no other complications exist, that the testicle itself has no torsion, and provide medication to help reduce any pain that your son may be having.

Practitioners Who Specialize In This Condition (16)

Bartley G. Cilento Jr., MD, MPH

Bartley G. Cilento Jr., MD, MPH

Pediatric Urologist, Department of Urology
Assistant Professor of Surgery, Harvard Medical School
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Caleb Nelson, MD, MPH

Caleb Nelson, MD, MPH

Vice Chair, Research; James and Valerie Mandell Endowed Chair of Pediatric Urology; Pediatric Urologist, Department of Urology
Associate Professor of Surgery and Pediatrics, Harvard Medical School
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Urology

The Department of Urology diagnoses and treats diseases of the urinary tract (kidneys, ureters, bladder, urethra) and male genitalia and reproductive tract in infants, children, and adolescents.

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