True about torsion of testis is all except

Pyuria is associated with epidydimo-orchitis, not with torsion of testis. Torsion is the twisting of the testis on the spermatic cord, resulting in strangulation of the blood supply and infarction of testis. It is seen commonly in adolescents (10-25 yrs) Symptoms - it presents as sudden agonizing pain in the groin and the lower abdomen. Nausea and vomiting are very common. It must be differentiated from epidydimo-orchitis by: Prehn's sign - on elevation of testis the: pain increases -in torsion pain decreases in epidydimoorchitis Colour Doppler-detects the decreased blood flow to testis in torsion. It is the inv. of choice to exclude torsion from the epididymo-orchitis. Tc99m peechnate scan - it demonstrates decreased blood flow Management Immediate surgical exploration is indicated if testicular torsion is suspected because if treated within the first 4 to 6 hrs of onset of symptoms, the chances of testicular salvage is high. During surgical exploration the testis is detorsed to restore blood flow to the testicle. If ble, orchipexy of the affected and the contralateral testis is done. If the affected testicle is nonble, orchiectomy of the affected testicle and orchipexy of the contralateral testis is done. If the operating facility is not immediately available, manual detorsion can be tried. Ref : Bailey & Love 25/e p1379