September 2022: The Torsed Testicle Traction Technique

I asked in my May blog whether immediate attempts at manual reduction of a testicular torsion should be the standard of care. Without a doubt, timely manual detorsion of a torsed testicle saves the organ from death. (Pediatr Emerg Care. 2019;35[12]:821; Pediatr Emerg Care. 2012;28[1]:80; https://bit.ly/3T9W0N0.)The detorsion procedure is sometimes quick and easy, but other times it is technically difficult and even unsuccessful. Unfortunately, many physicians are hesitant to attempt manual detorsion because they lack procedural confidence or have anxiety about worsening the torsion.Testicles torsed for a prolonged period will also have swelling and edema that, along with other mechanical factors, increase the difficulty of these rotation maneuvers. I described a maneuver involving downward traction of the torsed testicle that could potentially increase the procedural success rate. (https://bit.ly/3pCxaIa.)I can now report that I have successfully performed the maneuver on several patients and have named it the torsed testicle traction technique. This newly recognized technique was recently published (Pediatr Emerg Care. 2022 Aug 16. doi: 10.1097/PEC.0000000000002827) and is demonstrated with a model in the video​​. The testicular torsion traction technique may be a primary manual reduction maneuver for any testicular torsion, but it may be most useful as an adjunct for failed or difficult reductions. The spermatic cord can be pulled down like a te...
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