Regarding the management of testicular torsion, which statement correctly reflects the critical time-dependent salvage rates?

• A Orchidectomy rate is <5% if detorsion is performed within 6 hours; rises to >50% at 12-24 hours; salvage is near-zero beyond 24 hours
• B Orchidectomy rate is <10% if detorsion is within 12 hours and increases linearly thereafter
• C Testicular salvage is >90% if detorsion occurs within 6 hours; drops to approximately 50% at 12 hours; near 10% at 24 hours ✓
• D Colour Doppler absence confirms torsion; immediate orchidectomy is preferred over detorsion to prevent antisperm antibody formation

Explanation

Testicular salvage rates are time-critical: >90% if detorsion occurs within 6 hours, approximately 50% at 6-12 hours, and approximately 10% at 24 hours. The mechanism is ischaemia-reperfusion injury compounding the direct ischaemic damage from twisting (usually 360-720°). Manual detorsion ('open book' rotation outward — laterally) can be attempted while preparing for theatre but must not delay surgical exploration. Contralateral orchidopexy is performed simultaneously regardless, as bell-clapper deformity is usually bilateral. Doppler absence supports but does not mandate diagnosis; high clinical suspicion warrants immediate surgical exploration.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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