After what duration should manual detorsion no longer be attempted for testicular torsion?

Manual detorsion of the testes is a procedure performed to attempt to relieve testicular torsion, which is a surgical emergency. The timing of the detorsion is critical because the viability of the testicle diminishes significantly as time progresses. The risk of ischemia and subsequent necrosis increases after torsion, making timely intervention essential.

In general, if testicular torsion is not resolved within approximately 6 hours, the likelihood of salvage decreases markedly. By this time, the tissues may have suffered from considerable ischemic damage, leading to necrosis if blood supply has not been restored. While detorsion is an option, it becomes less advisable beyond this 6-hour mark due to the diminishing chances of testicular viability.

Therefore, the correct duration after which manual detorsion should no longer be attempted is 6 hours. Decision-making around testicular torsion must prioritize timely surgical intervention to maximize the chances of preserving the testicle. After this 6-hour threshold, surgical exploration becomes increasingly crucial, as waiting longer could result in permanent loss of the testicle.