the Importance of doppler ultrasound and physIchal examInatIon In dIagnosIs of testicular torsIon

Introduction: For cases of acute scrotum, exploration and detorsion is urgently required if testicular torsion is suspected. Scrotal doppler ultrasonography is important in the preoperative evaluation together with anamnesis and physical exami- nation. Despite its high sensitivity and specificity, it has to be kept in mind during diagnosis that doppler ultrasound may also have false negative and false positive results.

Methods:18 patients with testicular torsion were treated in our clinic between 2008-2017. Seven of them had the history of admission to another hospital with symptoms of scrotal swelling , hyperemia, pain and had been diagnosed as epididy- morchitis based upon normal or increased blood flow of testes on scrotal doppler ultrasound. They admitted to our clinic because of ongoing complaints despite oral antibiotherapy for about one week (3-10 days). Patients were urgently opera- ted with pre-diagnosis of testicular torsion as scrotal doppler ultrasonography in our institution revealed no testicular blood flow. Testes torsion was detected in all patients peroperatively and orchiectomy was performed for the necrotic testicles. Other eleven patients admitted directly to our hospital and they were urgently operated based upon the doppler ultraso- nography findings suggesting testicular torsion. Orchiectomy was performed in all of the patients.

Conclusion: Anamnesis and physical examination should also be taken into account together with scrotal ultrasonography findings, when evaluating patients presenting with acute scrotum. If there is doubt of testicular torsion, prompt surgical exploration should be performed.