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Question 8#

Regarding testicular torsion, which of the following is FALSE?

A. Undescended testicle is a risk factor
B. Decreased blood flow relative to contralateral testicle demonstrable by ultrasound
C. Testicular salvage decreases to <5% if surgery is delayed >6 hours
D. Surgical exploration should include fixation of the contralateral testicle

Correct Answer is C

Comment:

Risk factors for torsion include undescended testis, testicular tumor, and a "bell-clapper" deformity-poor gubernacular fixation of the testicles to the scrotal wall. The diagnosis is made by clinical history and examination, but can be supported by a Doppler ultrasound, which typically shows decreased intratesticular blood flow relative to the contralateral testis. Immediate surgical exploration can salvage an ischemic testis. More than 80% of testes can be salvaged if surgery is performed within 6 hours; this rate decreases to <20% as time lapses beyond 12 hours. At the time of surgery, the contralateral testes must also be explored and fixed to the dartos fascia due to the possibility that the same anatomic defect allowing torsion exists on the contralateral side.