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November 18, 1961

Torsion of the Testicle in ChildhoodA Painless Emergency Requiring Contralateral Orchiopexy

JAMA. 1961;178(7):702-705. doi:10.1001/jama.1961.03040460010002

In 5 out of 16 cases of testicular torsion the torsion was temporarily corrected in the office by manipulation under local anesthesia. Four patients were between 32 and 60 years old and insisted on carrying out corrective manipulation themselves. In 6 of the 12 patients under 21 years of age the scrotal swelling was discovered in the morning after a night's sleep. In only 3 of the 12 was severe pain associated with the initial torsion. At operation, the anomalous attachment of the tunica vaginalis on the affected side was also found on the contralateral side in 6 cases. Hence the author recommends that correction of the torsion on one side should be followed by immediate contralateral orchiopexy. Since sepsis is rare and a testicle damage by torsion may retain some endocrine activity, orchiectomy is to be avoided.