Testicular Torsion
Testicular torsion is a surgical emergency having an incidence that is probably underestimated at 1 in 4000 males. While torsion may occur at any age, its peak incidence is in adolescence (12 to 18 years) and the neonatal period. A prompt diagnosis is necessary to optimize the chance for testicular salvage by surgical exploration via detorsion and bilateral orchidopexy.
A careful history and physical examination should lead to the diagnosis of testicular torsion. Adolescents often present having the acute onset of lateralized scrotal or testicular pain that is intense, unaffected by position, and associated with nausea and vomiting. There are no associated voiding complaints, urethral discharge, or fever.
