In the treatment of testicular torsion, what is the recommended maneuver?

In the management of testicular torsion, the correct maneuver involves external rotation of the testicle, specifically recommended as 540 degrees. This technique aims to restore blood flow by untwisting the spermatic cord, which is twisted and causing ischemia to the testicle.

The rationale for the 540-degree maneuver is based on the need to ensure that the testicle is not just untwisted but rotated sufficiently to relieve the torsion effectively. This amount of rotation typically exceeds what may have initially occurred in most cases of torsion. The additional degrees ensure that the testicle is placed in a more physiologically favorable position, minimizing the chances of re-torsion.

This maneuver is a critical first step in the emergency treatment of testicular torsion, ideally performed urgently. However, surgical intervention is ultimately required to secure the testicle and prevent future torsion episodes, since if the testicle is re-twisted and allowed to remain unsafeguarded, it is at risk for recurrent torsion and potential loss.

Understanding this technique is crucial for emergency medicine practitioners as it can save the testicle if performed timely and correctly.