Torsion of spermatic cord and testicular appendages

Forty-seven cases of torsion of the spermatic cord and testicular appendages have been reviewed. Twenty-eight patients with acute spermatic cord torsions underwent surgical correction. Only 10 were treated in time to preserve viability. The other cases were either gangrenous and required orchidetomy or were questionably viable. Acute, painful scrotal swelling with negative e findings on urinalysis is a surgical emergency. Ten patients had warning attacks, but because of delay in diagnosis and treatment, 4 required orchidectomy. Those patients with spermatic cord torsion who were detorsed before twelve hours had elapsed had viable testes. Patients with complaints of intermittent scrotal sweling and pain, with negative urinalysis, may be suffering from intermittent patients were treated in this manner. Six of these had a transverse lie of both testes, which suggested the underlying anatomic defect leading to torsion of the spermatic cord. The diagnosis of epididymitis or epididymo-orchitis is untenable with a negative finding on urinalysis and results in delay incorrect diagnosis and treatment.