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Testicular Torsion — RACP Adult Medicine MCQ

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HardEmergency MedicineTesticular TorsionRACP Adult Medicine

A 30-year-old has six hours of sudden severe testicular pain, a high-riding testis and absent cremasteric reflex. What is the next step?

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Correct answer: D — Arrange immediate surgical exploration and bilateral orchidopexy before completing delaying for imaging

The best answer is “Arrange immediate surgical exploration and bilateral orchidopexy before completing delaying for imaging”. The clinical picture is testicular torsion, and salvage declines rapidly with time. Immediate urological exploration is required; Doppler imaging is used only when it will not delay surgery in an uncertain case. Manual detorsion may be a temporary manoeuvre while theatre is organised, but apparent relief does not replace fixation of both testes.

Reference: NSW Agency for Clinical Innovation: Emergency care clinical resources: https://aci.health.nsw.gov.au/networks/eci/clinical