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Case 140: Really painful scrotum

1. What is the diagnosis?

A torted testicle with established ischaemic necrosis

2. How should you proceed?

This testicle should be excised. This will decrease any pain and also lessen the incidence of the development of testicular antibodies against the opposite sided testicular contents. The other testicle should always be explored and fixed to prevent the other side torting at a later date - a preventable and disastrous outcome for the patient.