Testicular torsion in the pediatric age group: diagnosis and treatment

To review and update several aspects of testicular torsion.

The relative incidence of testicular torsion, torsion of testicular appendix and epididymo-orchitis is variable and depends on mode of diagnosis and patients' age. AGE: Testicular torsion can occur at any age. The peak is in adolescents below the age of 18 years.

Classical symptoms are not always present. Range of duration is varied. Nausea and vomiting are positive predictive value for testicular torsion.

Main findings predicting testicular torsion are absence of cremasteric reflex and diffuse tenderness.

Color Doppler Ultrasound can assess in equivocal and low clinical suspicious conditions for testicular torsion.

There are two conditions in this age group; the prenatal that urgent exploration is in controversy and postnatal that urgent surgery is required.

Early salvage rate and late atrophy depends on duration and degree of torsion.

Testicular torsion is an active area of malpractice litigation. Late presentation and atypical presentations do not affect the medicolegal outcome.