What is the most urgent action when torsion is suspected in any age group?

• A. Ultrasound imaging first in all cases
• B. Oral antibiotics and analgesics
• C. Bed rest and scrotal support only
• D. Immediate surgical detorsion

Answer: (D)

Torsion is a surgical emergency because twisting blocks blood flow to the affected gonad, causing rapid ischemia and risking loss of function if not promptly treated. The priority action is immediate detorsion—untwisting the structure to restore blood flow. Time matters: salvage rates drop quickly as hours pass, so waiting for imaging or starting conservative therapy can allow irreversible damage. Imaging like ultrasound with Doppler can support the diagnosis, but it should not delay definitive management when torsion is strongly suspected. After detorsion, definitive surgical care is usually performed to fix the structures and prevent recurrence.