What are Bell Clapper Testes?

The term Bell Clapper Testes describes testes that sit horizontally in the scrotum.  Testicles should normally sit up ‘vertically’ rather than horizontally.  It is a congenital abnormality of the testicle.

The abnormality normally affects both testes.  About 1 bout in every 125 is affected by this abnormality.

Testis lies in the scrotumt compared to a Normal Testis

What is the risk of Bell Clapper Testes?

A Bell clapper testis is able to move much more freely within the scrotum.  This means that the testis is at risk of Torsion (The testis twists on its blood supply).  If this happens the testis must be untwisted or else it will die.

How are they Diagnosed?

Bell Clapper Testes are diagnosed by clinical examination.  To be found, the patient must be standing up for the examination.  If the boy is not standing they can be easily missed.

As Bell Clapper Testes do not tend to cause any symptoms unless the testis twists on its blood supply (Testicular Torsion), they may be found incidentally when a patient is being examined for another reason.  Occasionally the boy complains of intermittent pain in one or other of the testicles.  This pain my be due to testis twisting and untwisting intermittently.

How are they treated?

Bell Clapper Testes can be treated by a day case operation to fix the testicles in the scrotum.  This operation is called Scrotal Fixation of Testes.

If your son develops pain in their testicle you should take them straight to your local Emergency Department. 

They may need an emergency operation to treat a torsion of the testicle.

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Scrotal Fixation of Testes

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