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Always remeber that most torsions twist inward and toward the mid line; thus, manual detorsion of the testicle involves twisting outward and laterally.

For example, in a suspected torsion of the right testicle, the physician is in front of the standing or supine patient and holds the patient’s right testicle with the left thumb and forefinger.

The physician then rotates the right testicle outward 180° in a medial to lateral direction.

Rotation of the testicle may need to be repeated 2-3 times for complete detorsion and to provide pain relief to the patient.

For the patient’s left testicle, the physician uses the right thumb and forefinger and rotates the patient’s left testicle in an outward direction 180° from medial to lateral.

Manual detorsion is successful in 26.5% to greater than 80% of patients based upon a number of reviewed studies.