A 16-year-old male presents to the emergency department with acute, severe pain in the left testicle starting three hours ago, accompanied by nausea but no vomiting. Physical examination reveals an abnormally high-riding left testicle and absent cremasteric reflex. What immediate intervention is critical for preserving testicular function?
Immediate testicular ultrasonography to confirm torsion
Secure parental consent before any medical intervention
Emergency manual detorsion followed by orchidopexy
The immediate intervention critical for preserving testicular function in suspected testicular torsion is emergency manual detorsion, followed by surgical fixation to prevent recurrence. Manual detorsion can provide interim relief of torsion until surgical intervention is undertaken. Surgical exploration confirms the diagnosis and allows for orchidopexy, which fixes the testes within the scrotum to prevent recurrence. Testicular ultrasonography, while useful for diagnosis, should not delay manual detorsion if torsion is highly suspected. Administration of pain medication, albeit necessary for patient comfort, does not resolve the underlying surgical emergency. Waiting for parental consent is not advisable when immediate action can prevent testicular loss.
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BCEN CEN
Gastrointestinal, Genitourinary, Gynecology, and Obstetrical
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