OBJECTIVETo improve the diagnosis and treatment of testicular torsion (or spermatic cord torsion), and reduce its misdiagnosis and mistreatment.

METHODSOne hundred and thirteen misdiagnosed clinical cases of testicular torsion from 1994 to 2004 were reviewed and analysed.

RESULTSThe error rate of initial diagnosis was 84.3%, among which 81 cases (71.7%) were misdiagnosed as acute epididymitis or testis, 10 (8.8%) as hydrocele of the tunica vaginalis, and 7 (6.2%) as acute enteritis. The lengths of time between the income and diagnosis of the disease varied from 2 hours to 2 months, averaging 6.3 days. Hand replacement succeeded in 3 cases, surgical examination was carried out in 92, resection of the testis or epididymis was performed in 64, testis atrophy occurred in 26, and the total testis impairment rate was 79.6%.

CONCLUSIONThe key to the reduction of misdiagnosis is to improve the diagnostic methods, which can be achieved by the combined use of case history, physical signs and color ultrasonography. Surgical examination of the scrotum is the best option for both the diagnosis and the treatment of testicular torsion.