Preoperative manual detorsion of the spermatic cord with Doppler ultrasound monitoring in patients with intravaginal acute testicular torsion

Objective. To assess the effectiveness of preoperative manual detorsion in acute testicular torsion. Materials and methods. Between June 1998 and March 1999, seven patients pre senting with testicular torsion underwent manual manipulation under US moni toring in order to restore the now to the testis prior to surgery (orchidop exy). All detorsions were lateral in direction. The success of the manoeuvr e was assessed both clinically and sonographically and confirmed at surgery . Results. Six manoeuvres were successful in restoring flow to the testis. Th e failed attempt in the seventh patient was due to failure to manipulate be yond an initial 1 1/2 rotations (540 degrees). Conclusions. Preoperative detorsion is the fastest way to relieve testicula r ischaemia. However, manual detorsion of the spermatic cord is not a subst itute for surgical exploration and bilateral orchidopexy is still necessary .