1. Scrotal exploration—if sufficiently concerned, surgery is the only investigation (and therapeutic procedure) required. This is performed under general anesthesia and final outcomes include—
7. SCROTAL PAIN AND SWELLINGS (EXCLUDING TUMORS) 225
• Orchidectomy (if testis non-viable)
• Contralateral orchidopexy if true torted testis
2. Doppler US scan—not indicated in the diagnosis of torsion (due to significant false-positive and false-negative results), but more useful for confirmation of absence of torsion if surgery not deemed necessary. Doppler techniques will demonstrate normal testicular blood supply.
3. Radionuclide imaging is useful in the evaluation of testicular blood flow but is time-consuming and relatively inaccurate for the diagnosis of acute torsion.
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