Falsely negative Doppler examinations in testicular torsion

Use of the Doppler ultrasonic flowmeter to assess testicular perfusion has potentially precise application in the evaluation of acute scrotal swelling. Recent reports suggest an almost infallible degree of accuracy in differentiating testicular torsion, with reduced or absent blood flow, from inflammatory processes, with accompanying increased vascular perfusion. This report of 4 falsely negative Doppler examinations confirmed by surgical exploration warns against relying on this as a single test in the diagnosis of testicular torsion. Only thorough clinical assessment of each patient and exploration in doubtful cases will assure maximum testicular salvage.