What are the key clinical signs and symptoms to consider when diagnosing testicular torsion in a young male patient?

Key clinical signs and symptoms for diagnosing testicular torsion in a young male patient include:

• Sudden onset of severe scrotal pain, often unilateral.
• Scrotal swelling and tenderness on the affected side.
• Possible nausea and vomiting accompanying the pain.
• High-riding testis or abnormal testicular position on examination.
• Absent or diminished cremasteric reflex on the affected side.
• Onset typically acute, requiring urgent assessment.

Because testicular torsion is a urological emergency, if suspected clinically, immediate hospital admission for surgical exploration is required to preserve testicular viability and fertility. Surgical intervention ideally occurs within 4 to 8 hours of symptom onset to prevent permanent ischemic damage to the testicle.

These clinical features distinguish torsion from other causes of acute scrotal pain such as torsion of the appendix testis, which may be managed conservatively.

Early recognition and referral are critical to avoid testicular loss.

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