{
  "schema_version": 1,
  "kind": "condition",
  "id": "testicular-torsion",
  "name": "Testicular torsion",
  "category": "acute",
  "sources": "ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class GD99.03 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Testicular Torsion - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK448199/ · Testicular torsion - disease-level clinical article (testicular-torsion-full.txt)",
  "review_status": "reviewed",
  "verified_against": "No dose - referral pathway, no medicine given in primary care · Testicular torsion - disease-level clinical article (testicular-torsion-full.txt)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 1771,
      "generic": "SURGICAL EMERGENCY - send now (Recognition & Referral)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": "A true surgical emergency, and one of the few conditions here where the right answer is to send the patient straight out of the door. The article is blunt: surgery is the only treatment, and testicular viability falls away sharply once 6 hours have passed since the symptoms began, which is why the diagnosis has to be early. Do not wait for reassuring imaging - where clinical concern is high, get the urological surgeon on the phone at once, because any delay can end in a necrotic testis and its loss. The window for surgery and salvage is usually the first 6 hours from the onset of pain. The operation is detorsion with fixation of BOTH sides: the contralateral testis is always secured in the same sitting, so that it cannot torse later. Keep the patient nil by mouth on the way - nothing to eat and nothing to drink, ready to go to theatre.",
      "adult_duration": "Send now - minutes matter",
      "dose_source": "No dose - referral pathway, no medicine given in primary care",
      "rationale": "A true surgical emergency, and one of the few conditions here where the right answer is to send the patient straight out of the door. The article is blunt: surgery is the only treatment, and testicular viability falls away sharply once 6 hours have passed since the symptoms began, which is why the diagnosis has to be early. Do not wait for reassuring imaging - where clinical concern is high, get the urological surgeon on the phone at once, because any delay can end in a necrotic testis and its loss. The window for surgery and salvage is usually the first 6 hours from the onset of pain. The operation is detorsion with fixation of BOTH sides: the contralateral testis is always secured in the same sitting, so that it cannot torse later. Keep the patient nil by mouth on the way - nothing to eat and nothing to drink, ready to go to theatre.",
      "cautions": [
        "RED FLAG - Do not give analgesia before urology has assessed the patient, since it can mask symptoms and delay diagnosis. The article puts the same instruction on the nursing staff: nothing for the pain until the urologist has seen him, because the analgesia hides the very signs the diagnosis rests on and pushes it back (Testicular Torsion - StatPearls - NCBI Bookshelf, NBK448199).",
        "This card carries no drug row and it is the only card in this app where WITHHOLDING a drug is the instruction. There is no analgesic row, no antibiotic row and no anti-emetic row, because the article's one sentence about pain medication says to hold it until the urologist has seen the patient.",
        "The clock is the prognosis. Present inside the first 6 hours and the testis is saved close to 100% of the time; leave it longer than 12 to 24 hours and the figure falls below 50%.",
        "If urology genuinely cannot be reached, manual detorsion is a bridge, not a treatment. The article's method: turn the affected testis from medial to lateral, like opening a book, through 180 degrees, then ask whether the pain has eased (Testicular Torsion - StatPearls - NCBI Bookshelf, NBK448199). The patient still goes to theatre afterwards.",
        "RED FLAG - Sudden severe scrotal pain, a high-riding or horizontally lying testis, an absent cremasteric reflex, or nausea or vomiting with scrotal pain."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Children follow the same pathway: recognise and refer. No primary-care medicine is implied.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "testicular-torsion"
    }
  ]
}