Testicular torsion is an emergent urologic condition that, without prompt assessment, diagnosis, evaluation, and treatment, portends a low success rate for testicle salvage. In testicular torsion, the spermatic cord (which provides blood flow to the testicle) rotates or twists, cutting off its blood supply and causing acute pain and swelling. Testicular torsion is most common in boys aged 12-18 years old. It can occur after strenuous exercise, after trauma to the scrotum, or during sleep. Signs and symptoms include unilateral swelling, nausea, vomiting, and abdominal pain. Testicular torsion is diagnosed by physical examination and confirmed by diagnostic ultrasound. Treatment includes manual detorsion (i.e., an attempt to untwist the spermatic cord by pushing on the scrotum) or surgery. Chance of testicular salvage decreases significantly after approximately 6 hours. Patients with testicular torsion will complain of severe pain, are easily recognized, and require rapid evaluation and surgical evaluation. Such a patient should not be assigned to the waiting area and must be seen right away.
Testicular Torsion II