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Testicular Torsion — MRCEM SBA MCQ

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HardUrologyTesticular TorsionMRCEM SBAUKMLAPARAMRCGP AKT

A 30-year-old has sudden severe unilateral scrotal pain and swelling. The testis is high riding and the cremasteric reflex is absent. What should be communicated when obtaining urgent urological help?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Treat as testicular torsion pending exploration

The best answer is “Treat as testicular torsion pending exploration”. Sudden severe pain, high-riding testis and absent cremasteric reflex are highly concerning for testicular torsion. It must be treated as a surgical emergency until excluded by the urological team, without delay for outpatient imaging or urine testing. Epididymo-orchitis has a different typical tempo and does not justify delaying exploration when torsion is likely.

Reference: NICE CKS: Scrotal pain and swelling: https://cks.nice.org.uk/topics/scrotal-pain-swelling/