Torsion of the Testis1

SUMMARY A review of the literature of torsion suggests that 90 per cent, of cases of torsion lose the testis, 80 per cent, by orchidectomy, 10 per cent, by subsequent ischemic atrophy. Thirty‐eight patients with torsion of the testis treated in Leeds from 1950 to 1962 have been reviewed with the object of improving our diagnosis and assessing the treatment. The condition is not as rare as suggested, and probably three to four patients per year are treated in any busy general hospital. It is primarily a disease of adolescence and any boy below the age of 18 years with an acute painful swelling of the testis and normal urine is probably suffering from torsion and not epididymitis. The predisposing factor in torsion, that is the developmental anomaly, is bilateral. Treatment should be immediate exploration and fixation of the testis, even if the symptoms have subsided and resolution occurred. Fixation should also be carried out in recurrent torsion. The opposite testis should always be explored and fixed at the time of the original operation.