Torsion of the testis.

Torsion of the testis demands early diagnosis and urgent operative treatment. This study of all patients with torsion of the testis who were admitted to The Prince of Wales Children's Hospital, The Prince of Wales Hospital and The Prince Henry Hospital, Sydney, between 1965 and 1987, reinforces the need for urgent diagnosis and treatment and evaluates the diagnostic value of the sign of the contralateral horizontal testis. One hundred and thirty-one patients were studied; the majority was in the adolescent age-group. If operation were delayed beyond 24 hours without spontaneous relief of the symptoms or manipulative detorsion being performed, then at follow-up 5.5% of testes were normal; however, if operation were performed within 24 hours of the onset of symptoms, 90% of testes were normal at follow-up. In all cases in which it was sought, the sign of the contralateral horizontal testis was found, which confirms the bilaterality of the condition and that a high investment of the tunica vaginalis predisposes to torsion of the testis.