What is the definitive treatment for testicular torsion?

What is the definitive treatment for testicular torsion?

• A. Surgical exploration
• B. Manual detorsion
• C. Observation
• D. Orchiopexy

Answer: (A)

Testicular torsion is a urologic emergency where the blood supply to the testicle is acutely cut off. The only definitive way to resolve this and prevent recurrence is urgent surgical exploration. During the procedure, the testis is untwisted (detorsion) and then fixed in place on both sides (orchiopexy) to prevent future torsion. This approach not only restores blood flow and allows assessment of viability but also protects the remaining testis from torsion. Manual detorsion can be attempted as a temporary measure to relieve symptoms and buy time for surgery, but it is not definitive. It carries uncertainty about direction of twist, may fail, and does not address the risk to the contralateral testicle. Observation is inappropriate because delays can lead to irreversible testicular damage. While fixation (orchiopexy) is essential, it is typically performed in the context of surgical exploration to ensure proper detorsion and assess viability.

Testicular torsion is a urologic emergency where the blood supply to the testicle is acutely cut off. The only definitive way to resolve this and prevent recurrence is urgent surgical exploration. During the procedure, the testis is untwisted (detorsion) and then fixed in place on both sides (orchiopexy) to prevent future torsion. This approach not only restores blood flow and allows assessment of viability but also protects the remaining testis from torsion.

Manual detorsion can be attempted as a temporary measure to relieve symptoms and buy time for surgery, but it is not definitive. It carries uncertainty about direction of twist, may fail, and does not address the risk to the contralateral testicle. Observation is inappropriate because delays can lead to irreversible testicular damage. While fixation (orchiopexy) is essential, it is typically performed in the context of surgical exploration to ensure proper detorsion and assess viability.