Surgical Management of Testicular Torsion

Abstract

Once the diagnosis of testicular torsion has been confirmed, time is of the essence to detorse the testicle to preserve testicular viability. To buy time, an attempt can be made to detorse the affected testicle manually prior to taking the patient to the OR for scrotal exploration. This can be done by turning the affected testicle laterally. If successful, the patient will have relief of pain. Manual detorsion may be successful in up to 50 % of attempts. Even if manual detorsion appears successful, scrotal exploration is required to confirm testicular viability and to perform testicular fixation if the testicle remains viable. Intraoperative testicular fixation is imperative to prevent torsion recurrence. If the affected testis appears necrotic, then orchiectomy may be required.