Survival of a Torsed Testicle

​The time for possible salvage and survival of a torsed testicle is commonly thought to be six to eight hours, a period that is expressed with confidence by the medical and legal professions. Survival of torsed testicles with and without subsequent atrophy is known to occur outside that critical window. My colleagues recently treated a 17-year-old boy approximately three days after the onset of right scrotal pain. He reported his pain constantly as 8/10 in severity. He didn't tell his mother for several days because he was scared, embarrassed, and hoping that the pain and swelling would resolve.​The patient was taken to the operating room approximately 70 hours after the onset of his testicular torsion. The cyanotic, 360-degree torsed left testicle pinked up and was deemed viable in the OR. The patient reported a week later that he was experiencing no pain and that his testicle seemed to be completely back to normal. Consider for a minute if the urologist had elected not to take the patient to the operating room that night. The outcome would have been much different, and an otherwise salvageable testicle would have died.The potential for subsequent testicular atrophy is acknowledged, but no one knows for sure. Is there a clear-cut time when it is futile to rush to the operating room? If there is, it probably has to be based on other physical and ultrasonographic findings in addition to time.It is true that torsed testes have been found to be necrotic after just six or few...
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