Manual derotation of the twisted spermatic cord


Dr Cornel Department of Urology, Academic Hospital Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands.



To re-emphasize the safety and efficacy of manual derotation in the management of the twisted spermatic cord.

Patients and methods

Seventeen patients (mean age 15 years, range 13–28) with acute unilateral torsion of the spermatic cord, initially treated by manual detorsion, were reviewed; all 17 patients were seen by one consulting urologist (H.F.M.K.).


In 14 of the 17 patients the attempt resulted in successful manual derotation, i.e. the immediate relief of all symptoms and normal findings at physical examination. No testicular atrophy was detected during the follow-up (mean 22 months, range 9–72).


These results reinforce the efficacy and safety of manual derotation with subsequent elective bilateral orchidopexy as the primary treatment for the twisted spermatic cord.