eMedicine Specialties > Radiology > Genitourinary

Testicular Torsion: Follow-up

Author: , Vice Chair, Vice Chair, Department of Radiology, The University of Chicago
Contributor Information and Disclosures

Updated: Mar 10, 2008

Intervention

The suspicion of testicular torsion requires immediate surgical intervention to provide testicular salvage.27 Detorsing of the involved testis, with bilateral orchiopexy, is the standard surgical approach. This treatment is preferred because of the subsequent increased risk of future contralateral torsion. If the testicle is nonviable, orchiectomy is usually performed. Many patients with classic symptoms and signs of torsion require no imaging corroboration, and ultrasonography or nuclear medicine examinations should be reserved for those presenting with atypical symptoms.

Testicular torsion is highly suspected if the following are present: appropriate age group, classic presentation, and consistent physical findings. In such cases, urgent operative repair can be undertaken without imaging verification.

The normal contralateral testicle is at increased risk for torsion, and preventive orchiopexy is therefore performed.

Spontaneous detorsion of the testis does occur, and it still requires surgical attention, even after the fact.

Patient Education: For excellent patient education resources, visit eMedicine's Men's Health Center. Also, see eMedicine's patient education article Testicular Pain.

Medicolegal Pitfalls

  • Clearly, surgical exploration of suspected torsion without imaging corroboration is fully acceptable because of the high morbidity rates associated with delayed treatment and the low morbidity rate of exploration.
    • However, once an imaging examination is requested, the performing physician must consider all potential diagnoses and report the imaging findings as clearly, concisely, and unambiguously as possible.
    • If the possibility that the patient has torsion remains, he should be treated as such, and surgical exploration is indicated.
  • If a surgical specialist still considers the diagnosis of torsion unlikely, nuclear scintigraphy may provide useful confirmatory information if the sonographic findings are ambiguous.

See also the Medscape topic Medical Malpractice and Legal Issues.


 


More on Testicular Torsion

Overview: Testicular Torsion
Imaging: Testicular Torsion
Follow-up: Testicular Torsion
Multimedia: Testicular Torsion
References
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References

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Further Reading

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Keywords

torsion of the spermatic cord, spermatic cord torsion, extravaginal torsion, intravaginal torsion, torsed testis, torsed testes, torsed testicles, retorsion, detorsion

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Contributor Information and Disclosures

Author

, Vice Chair, Vice Chair, Department of Radiology, The University of Chicago
, Vice Chair is a member of the following medical societies: American College of Radiology, American Institute of Ultrasound in Medicine, Chicago Medical Society, Illinois State Medical Society, and Radiological Society of North America
Disclosure: Nothing to disclose.

Medical Editor

John L Haddad, MD, Clinical Associate Professor, Department of Radiology, Weill Medical College of Cornell University; Director of Body MRI, Department of Radiology, Methodist Hospital in Houston
John L Haddad, MD is a member of the following medical societies: American College of Radiology, American Medical Association, and Radiological Society of North America
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Arnold C Friedman, MD, FACR, Associate Chairman, Department of Radiology, University of Florida Health Science Center; Chief, Department of Radiology, Shands-Jacksonville Hospital
Arnold C Friedman, MD, FACR is a member of the following medical societies: American College of Radiology, American Institute of Ultrasound in Medicine, American Roentgen Ray Society, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Clinical Assistant Professor of Radiology, University of Washington School of Medicine; Consulting Radiologist, Virginia Mason Medical Center
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

 
 
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