Highlights & Basics
- Testicular torsion is a urologic emergency.
- A high index of suspicion is important to ensure timely diagnosis and management.
- Increased public awareness is important in reducing embarrassment and increasing the number of patients presenting within 6 hours of symptoms developing.
- A history and physical exam consistent with testicular torsion mandates an immediate surgical consult for scrotal exploration.
- If history and physical exam suggest testicular torsion, immediate surgical consultation and exploration should take precedence over diagnostic tests.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Intraoperative photograph showing extravaginal torsion of the spermatic cord and the necrotic testis in a newborn with discoloration of the right testicle at birth
Longitudinal ultrasound scan in a newborn with discoloration of the right testicle at birth showing the testis (T) surrounded by a highly echogenic tunica (arrows), which is probably calcified; a complex hydrocele (h) with several septa occupies the scrotal sac
Bilateral transverse color Doppler images in a 12-year-old boy with right-sided scrotal pain of sudden onset, showing no color flow signals in the right testis, which is enlarged and has heterogeneous echogenicity; reactive hydrocele (h) and thickening of the scrotal wall (*) are also seen; testicular torsion and bell clapper deformity were confirmed at surgery
Citations
National Confidential Enquiry into Patient Outcome and Death. Testicular torsion. Feb 2024 [internet publication].[Full Text]
Royal College of Surgeons of England. Commissioning guide topics: management of paediatric torsion. Oct 2016 [internet publication].[Full Text]
European Association of Urology. Paediatric urology. Mar 2023 [internet publication].[Full Text]
Expert Panel on Urological Imaging:, Wang CL, Aryal B, et al. ACR appropriateness criteria: acute onset of scrotal pain-without trauma, without antecedent mass. J Am Coll Radiol. 2019 May;16(5s):S38-43.[Abstract][Full Text]
Clement KD, Light A, Asif A, et al. A BURST-BAUS consensus document for best practice in the conduct of scrotal exploration for suspected testicular torsion: the Finding consensus for orchIdopeXy In Torsion (FIX-IT) study. BJU Int. 2022 Jun 10;130(5):662-70.[Abstract][Full Text]
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