Torsion of the testis.

The diagnosis of torsion of the testis is notoriously difficult, and many cases are missed at the early stage when treatment may save the organ. Diagnostic errors are made simply because practitioners and surgeons are not familiar with the condition or do not bear in mind this possibility. 'There is no doubt that many cases of testicular torsion are misdiagnosed as acute epididymitis and time is lost in the ineffectual treatment of an inflammatory condition. When the correct diagnosis is made, the testis is found on exploration to be infarcted and has to be removed. Alternatively if not explored it undergoes gradual complete atrophy. Early diagnosis and treatment can prevent these disasters. O'Conor (1933) questioned all patients he saw who had atrophied testes and came to the conclusion that torsion was quite common. Riba and Schmidlapp (I946) estimate that 75% of twisted testes are lost, and state that it is better to explore a case of epididymitis than miss a case of torsion.