Conservative management of twisted testicular appendages

We planned non-operative treatment of a twisted intrascrotal appendage in 23 consecutive patients, ranging in age from 6 to 45 years, in whom the diagnosis could be made confidently. Only 3 patients have required subsequent removal of the infarcted appendage because of persistent or recurrent pain. The remaining patients became free of pain within a week. Prompt surgical exploration to exclude torsion of the spermatic cord remains necessary if scrotal swelling obscures the diagnosis. At operation for the latter indication 5 additional boys were found to have a twisted appendix testis during the study interval.