What is the initial management for testicular torsion?

What is the initial management for testicular torsion?

• A. Observation
• B. Antibiotics
• C. Try to reverse (manual detorsion) followed by surgery
• D. Heat therapy

Answer: (C)

Testicular torsion is an emergency because the blood supply to the testis is acutely compromised, and salvaging the testicle depends on quickly restoring perfusion. The initial management is to untwist the spermatic cord as soon as possible—this can be attempted manually (detorsion) to relieve the twist and reestablish blood flow. After this temporary measure, urgent surgical exploration is needed to confirm viability and to fix the testis in place (orchiopexy), usually of both testes to prevent recurrence. Time is crucial, as salvage rates fall rapidly after several hours. Options like observation, antibiotics, or applying heat do not address the ischemia and can waste valuable time.

Testicular torsion is an emergency because the blood supply to the testis is acutely compromised, and salvaging the testicle depends on quickly restoring perfusion. The initial management is to untwist the spermatic cord as soon as possible—this can be attempted manually (detorsion) to relieve the twist and reestablish blood flow. After this temporary measure, urgent surgical exploration is needed to confirm viability and to fix the testis in place (orchiopexy), usually of both testes to prevent recurrence. Time is crucial, as salvage rates fall rapidly after several hours. Options like observation, antibiotics, or applying heat do not address the ischemia and can waste valuable time.