Inflammation With a Twist: A Rare Urologic Case Report

Testicular torsion is a urological emergency that requires prompt recognition and intervention. Although it most commonly affects two age groups, including neonates and adolescents, it can occur at any age. Risk factors to consider include anatomic abnormalities, trauma, testicular tumors, and family history. Typical clinical presentation involves an acute onset of severe scrotal pain, a high-riding testicle, and an absent cremasteric reflex. We report an unusual case of a 63-year-old man who presented with a two-week history of progressive scrotal pain and swelling and was found to have concurrent testicular torsion and a large scrotal abscess. This atypical and delayed presentation highlights the diagnostic challenges of testicular torsion in older adults.