Testicular Torsion

Twisting of the spermatic cord, leading to ischemia and possible testicular infarction; painful scrotal swelling; pain remains the same on increased with scrotal elevation (- Prehn's sign); pain accompanied with nausea and vomiting

• History / PE:
  Doppler U/S shows decreased blood flow to testes (as opposed to epididymitis )
• Treatment:
  Attempt manual detorsion
  Immediate surgery to salvage testes (often insalvageable after 6 hrs)
  Orchioplexy of BOTH testes to prevent future torsion