Incidence of the bell-clapper deformity in an autopsy series.

OBJECTIVES: Testicular torsion is seen in all age groups. The bell-clapper deformity (BCD) when present predisposes the patient to torsion. This study was undertaken to determine the incidence of the BCD.

METHODS: An autopsy series of 51 males with 101 testes was dissected by the senior author to determine the incidence of the BCD.

RESULTS: The manner of testicular investment by the tunica vaginalis was classified as normal, intermediate, or absent (BCD). Seventy-six testes were normal, 13 were intermediate, and 12 were of the bell-clapper type.

CONCLUSIONS: The incidence of the BCD in this autopsy series was 12%. Because the incidence of testicular torsion in the general population is far less than 12%, other factors in addition to anatomic predisposition must be involved.