Testicular torsion, time is of the essence: a case for testicular preservation


  • Klaudia Cios NYIT College of Osteopathic Medicine, Old Westbury, NY, USA
  • Daniel Kohn Department of Surgery, Flushing Hospital Medical Center, Queens, NY, USA
  • Philip Hall Ross University School of Medicine, Barbados
  • Alek Mishail Department of Surgery, Flushing Hospital Medical Center, Queens, NY, USA
  • Martine Louis Department of Surgery, Flushing Hospital Medical Center, Queens, NY, USA




Testicular torsion, Intermittent testicular torsion, Pediatric


Testicular torsion around the spermatic cord causes arterial and venous occlusion, which can lead to swelling, ischemia, and eventually necrosis of the testicle. It is a urologic emergency that requires a time-dependent diagnosis to prevent testicular loss. This is a case report of an atypical presentation of a 15-year-old male with a 5-day history of testicular torsion, that resulted in preservation of testes viability immediately after detorsion and at 4-week follow-up.



Sharp VJ, Kieran K, Arlen AM. Testicular torsion: diagnosis, evaluation, and management. Am Fam Phys. 2013;88(12):835-40.

Hyun GS. Testicular Torsion. Rev Urol. 2018;20(2):104-6.

Jacobsen FM, Rudlang TM, Fode M, Østergren PB, Sønksen J, Ohl DA, et al. The Impact of Testicular Torsion on Testicular Function. World J Mens Health. 2020;38(3):298-307.

Zhao LC, Lautz TB, Meeks JJ, Maizels M. Pediatric testicular torsion epidemiology using a national database: incidence, risk of orchiectomy and possible measures toward improving the quality of care. J Urol. 2011;186(5):2009-13.

Mellick LB, Sinex JE, Gibson RW, Mears K. A Systematic Review of Testicle Survival Time After a Torsion Event. Pediatr Emerg Care. 2019;35(12):821-5.

Bandarkar AN, Blask AR. Testicular torsion with preserved flow: key sonographic features and value-added approach to diagnosis. Pediatr Radiol. 2018;48(5):735-44.

Barco-Castillo C, Sánchez D, Fernández N. Performance of the TWIST Score in Patients with Testicular Torsion that Present to the Emergency Department. Urol Colomb. 2020;29:225-30.

Pan P. Validation of the Testicular Workup for Ischemia and Suspected Torsion (TWIST) Score in the Diagnosis of Testicular Torsion in Children With Acute Scrotum. Indian Pediatr. 2020;57(10):926-8.

Sheth KR, Keays M, Grimsby GM, Granberg CF, Menon VS, DaJusta DG, et al. Diagnosing Testicular Torsion before Urological Consultation and Imaging: Validation of the TWIST Score. J Urol. 2016;195(6):1870-6.

Brenner JS, Ojo A. Causes of Scrotal Pain in Children and Adolescents - Edited by: Middleman AB, Baskin LS, Neuman MI. UpToDate. Available at: https://www.uptodate.com/contents/causes-of-scrotal-pain-in-children-and-adolescents. Accessed on 17 May 2022.

Yang C, Song B, Tan J, Liu X, Wei GH. Testicular torsion in children: a 20-year retrospective study in a single institution. Scientific World J. 2011;11:362-8.

Lian BS, Ong CC, Chiang LW, Rai R, Nah SA. Factors Predicting Testicular Atrophy after Testicular Salvage following Torsion. Eur J Pediatr Surg. 2016;26(1):17-21.

Mäkelä EP, Roine RP, Taskinen S. Paternity, erectile function, and health-related quality of life in patients operated for pediatric testicular torsion. J Pediatr Urol. 2020;16(1):44.






Case Reports