Real-time Ultrasound-Guided Manual Testicular Detorsion: A Case Report

Area of Science:

• Urology
• Emergency Medicine
• Diagnostic Imaging

Background:

• Acute testicular torsion is a critical surgical emergency caused by testicular ischemia.
• Manual detorsion is a vital bedside intervention to save the testis.
• Current methods relying on pain relief alone may not guarantee complete detorsion, with residual torsion observed in up to one-third of cases.

Purpose of the Study:

• To present a case illustrating the effectiveness of color Doppler ultrasound in confirming complete manual detorsion.
• To highlight the role of ultrasound guidance in optimizing manual detorsion outcomes.

Main Methods:

• A case report of a 14-year-old male with acute testicular torsion.
• Initial 360-degree manual detorsion followed by pain assessment.
• Color Doppler ultrasound evaluation to assess testicular blood flow.
• Additional 180-degree detorsion guided by ultrasound.

Main Results:

• Pain relief was achieved after the initial 360-degree detorsion.
• Color Doppler ultrasound initially showed incomplete return of blood flow.
• An additional 180-degree turn, guided by ultrasound, resulted in the complete restoration of normal vascular flow to the testis.

Conclusions:

• Timely restoration of testicular blood flow is paramount for testicular viability.
• Color Doppler ultrasound provides real-time visualization to ensure complete and accurate manual detorsion.
• Ultrasound guidance enhances the efficacy of bedside manual detorsion, optimizing outcomes before surgical intervention.