Bell Clapper Deformity Pictures, Test, Symptoms, Causes, Treatment

Bell Clapper Deformity is a congenital anatomical disorder in which there is an innate lack of gubernaculum, the back fixation of the tunica vaginalis to the scrotum. With bell clapper deformity, testicles are poorly connected to the scrotum and able to move freely in the scrotal sack and bend around the axis of the blood vessels. Bell clapper deformity is usually bilateral in about 60% to 70% of such cases.

Bell clapper deformity leaves testicles  to rotate and swing within tunica vaginalis just like clapper inside of a bell. This condition may lead to testicular torsion around the axis of the seminal cord that is termed as spermatic cord torsion.

Deformation itself is difficult to detect from radiographic images. However, there are some specific findings in case of MRI for example an abnormal direction of the longitudinal axis of the testicles and irregular pattern of fluid collection inside the cavity of tunica vaginalis.

About 40% to 60% cases of Bell clapper deformity lead towards testicular torsion while rest of the cases does not cause torsion and ischemia. Torsion usually occurs when mesorchium becomes abnormally long and allows testicles to bend and twist around its own axis. Possible causes of bell clapper deformity and testicular torsion are forceful contraction of cremasteric muscle, trauma, sexual intercourse and strenuous activity.

 Bell Clapper Deformity Pictures

Bell Clapper Deformity Tests

It is difficult to diagnose bell clapper deformity via physical examination because it is cannot be observed with naked eye. For this purpose you healthcare provide may ask you you to perform some radiographic as well as sonographic test for clear diagnosis. Lower abdominal ultrasound with special focus to testicular region is beneficial in this regard. However, sometimes it is necessary to perform MRI if ultrasound does not provide adequate results.

Bell Clapper Deformity Symptoms

Symptoms of bell clapper deformity are not so much obvious unlike other testicular abnormalities. However, following signs must be kept in consideration as far as bell calpper deformity is concerned.

• Presence of blood in semen
• Nausea
• Vomiting
• Lumps in the scrotal region
• Swelling in the scrotum
• Lower abdominal pain
• Painful urination

Bell clapper deformity Causes 

Bell calpper deformity may occur at any age with or without obvious cause. Some commonly known factors that results in bell clapper deformity are trauma, accidental injury to testes, birth defect, strenuous activity, cremasteric muscle stretchiness, cold temperature and aggressive testicle growth during puberty.

Bell clapper deformity Treatment

There is no therapeutic treatment for bell clapper deformity. Surgery is the mainstay for such problem. In this surgeon will make a small incision in your scrotum, untwist your spermatic cord and then stitch one or both testicles. Only 2-5% of the cases require removal of testicles due to secondary complications.