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I'm assuming it's under procedural sedation?   And, what's the trick to determine if the torsion is medial or lateral?

 

Great discussion...................Pam Murphy

 



 

 
 
 
Pamela S. Murphy, MD
 
Mendy's Place
John C. Lincoln Hospital Deer Valley
 
Myelomeningocele Planning Clinic
Children's Rehabilitative Services
St. Joseph's Hospital


 

> Date: Tue, 11 Aug 2009 22:07:14 -0400
> From: [log in to unmask]
> Subject: Re: manual detorsion?
> To: [log in to unmask]
> 
> I have been surprisingly successful with manual detorsion in the ED. It's my first line therapy when the diagnosis is clear. 2/3 of our urologists support this approach, feeling that we can't really make it worse. So far I've done far more manual detorsions than sent kids to the OR emergently. (Watching the detorsion does give some of the male residents a little nausea!)
> 
> Complete resolution of the pain and swelling is virtually diagnostic. The urologists generally are happier scheduling a nonemergent procedure in a few days.
> 
> "Time is testicle"
> 
> Jeremy Larson
> Nationwide Children's Hospital
> Columbus, OH
> 
> 
> ________________________________
> 
> From: Pediatric Emergency Medicine Discussion List on behalf of Jay Fisher
> Sent: Mon 8/10/2009 12:31 AM
> To: [log in to unmask]
> Subject: manual detorsion?
> 
> 
> 
> Clinicians and Scholars-
> 
> How many of you employ manual detorsion of the testes in your ED practice?
> 
> Has the data demonstrating that one third of torsions occur laterally made
> an impact on your approach? (Sessions AE et al. J Urol 2003
> Feb;169(2):663-5.
> 
> 
> Jay D. Fisher MD FAAP
> Director of Pediatric Emergency Services
> Emergency Physicians Medical Group
> University Medical Center, Las Vegas NV
> St. Rose Sienna Hospital, Henderson NV
> 
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For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
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