Diagnosis
Treatment
Immediate urologic consultation for surgical exploration.
“Surgical exploration is the immediate priority, with ischemic damage starting between 4 and 8 hours after onset. Attempts at manual detorsion should not delay surgical exploration and often require analgesia or sedation. If surgery is not an immediate option, manual detorsion is performed by rotating the testicle from medial to lateral, like opening a book. Doppler ultrasonography is the imaging modality of choice, but it delays surgical exploration and should be used only when the history and physical examination make the diagnosis questionable.” ABFM
“The patient has typical signs and symptoms of testicular torsion despite inconclusive ultrasonography. Surgical exploration is necessary because the testicle can be salvaged if the torsion is repaired within 6 hours of symptom development (SOR C).” ABFM
Reference
Am Fam Physician 2014;89(9):723-727. Epididymitis: An Overview. https://www.aafp.org/afp/2016/1101/p723.html