What is the treatment of choice for testicular torsion?

The treatment of choice for testicular torsion is emergency surgery. Testicular torsion involves the twisting of the spermatic cord, which can compromise blood flow to the testicle and lead to irreversible damage if not treated promptly.

Surgical intervention is critical because it not only untwists the cord (detorsion) but also involves fixation of the testicle to prevent recurrence, a procedure known as orchidopexy. The urgency of surgery stems from the time-sensitive nature of the ischemic injury to the testicle; ideally, surgery should occur within 6 hours of the onset of symptoms to maximize the chance of testicular salvage.

While manual detorsion can be attempted as an immediate measure in some cases, it is not a definitive or reliable long-term solution compared to surgical fixation. Observation would not be appropriate as the condition is an urgent surgical emergency, and antibiotics are not indicated as the primary treatment because the underlying issue is not an infection but rather a torsion needing surgical correction.