Post Testicular Torsion Surgery

Dear Ask The Doctor: My son had surgery 24 hrs ago for Testicular Torsion. By the time it was performed it had been over 24 hrs....possibly even 48. Not sure. The surgeon chose not to remove it, saying he didn't think it had a good chance, maybe less than 50%. Why leave it in? Is there really any chance at all that it will be ok? Won't it cause more problems if left in to shrivel up and die? How long til we know if it makes it or not?

Dear Pam: Most surgeons opt for removal of the testicle if there is any doubt as to viability when performing surgery for testicular torsion.  I cannot say  why your son's surgeon chose not remove his testicle despite his stated apprehension about its viability. Should the testicle prove not viable, there is an increased risk of decreased fertility even after the testicle is removed at a later date. Viability can be determined by performing a Doppler ultrasound. This test will give information about the blood flow within the testicle. Little or no blood flow means that the testicle is dead and needs to be surgically removed. If this test has not already been done, it should be done soon.