Diagnosis of testicular torsion with preserved blood flow detected by color Doppler ultrasonography

Background To diagnose testicular torsion promptly and accurately when diagnosis of testicular torsion is difficult by color Doppler ultrasonography owing to testicular blood flow, we assess the helpfulness of physical findings to aid diagnosis of testicular torsion in cases with preserved testicular blood flow. Methods We retrospectively collected data of 45 patients below 18 years of age with suspected diagnosis of testicular torsion and underwent surgery. The clinical data of testicular torsion with normal testicular blood flow were compared to testicular torsion with normal testicular blood flow or no-testicular torsion for accurate diagnosis of testicular torsion. Results Testicular torsion was diagnosed in 34 of the 45 patients, and normal testicular blood flow was detected in six of the 34 patients. In testicular torsion with normal flow, duration of symptoms was significantly shorter, and the degree of torsion was significantly more mild than decreased blood flow. All testicular torsion with normal testicular flow had abnormal testicular findings. Duration of symptoms in patients with testicular torsion with normal flow was also significantly shorter than non-testicular torsion. Conclusions If testicular blood flow is detected, the presence of abnormal testicular findings and short duration of symptom are highly suspicious for testicular torsion.