Sudden testicular pain

A 32 year old male presented with sudden testicular pain while sleeping. Pain is 10 out of 10 and is more in right side radiating to abdomen. Patient took painkiller but very less relief, pain reaches 9 from 10 after painkiller. Patient is married and is sexually active with his wife only. Patient smokes & drinks occasionally. On examination right testicle is inflamed and tender on touch. No lymph node swelling noted. Colour doppler ultrasound shows reduced arterial flow in the testicular artery. Can you tell the diagnosis and next investigation step?

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Color Doppler reported reduced blood flow sigh of torsion of testes may be due incomplete twisting of the cord . Not rely or wait on other clinical signs which may or may not be elicited in due course of time Pt needs urgent exploration of the testes and untwisting of the cord with orchidoprexy Manual untwisting of cord may be done but after doing this procedure to see the intensity of signs(pain) has reduced or not and to wait for it causing unnecessary wastage of time which may cause damage if the testes.
Surgical repair, or orchiopexy, is usually required to treat testicular torsion. In rare cases, may be able to untwist the spermatic cord by hand. This procedure is called “manual detorsion.” Surgery is performed as quickly as possible to restore blood flow to the testicles and to preserve fertility.
? TESTICULAR TORSION.. ? VASCULAR DISEASE OF TESTES.. NEED'S.. CLINICOPATHOLOGICAL EVALUATION WITH.. CDUS .. SUTDY. . TESTES.. SURGEONS OPINION FOR FURTHER MANAGEMENT.. MEANWHILE TREAT SYMPTOMATICALLY WITH.. INJECTION.. TRAMADOL / DYNAPAR .. AS PER EXPERTS OPINION..
Tnx Dr Sandeep S
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TESTICULAR torson. Surgical intervention to repair or orchiopexy is required to avoid further complications or eventuality.
Thanks Dr Parveen Yograj
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Incomplete testicular torsion . An operation with untwisting of testis and orchidopexy is indicated as early as possible
Torsion of testis.surgery asap.
??sign of testicular torsion. When the testicle rotates(testicular torsion) it twist the cord supplying blood to the loose bag of skin(scrotum) beneath the penis. This may occur after vigorous activity,a minor injury to the testicles of sleep. Scrotal Doppler ultrasonography
Epididymoorchitis dd torsion of testis dd varicocoele
Epidedimo orchitis due to pressure innury

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