Surgical exploration may be necessary if a diagnosis cannot be made using other methods. If there is the slightest hint of a torsion of the testicle, then doctors will perform surgery; even if the testicle turns out not to have twisted, they will still protect it by attaching the testicle to the scrotum wall.

With prompt diagnosis and treatment the testicle can be saved in a high number of cases.^[1]

Testicular torsion is a medical emergency that needs immediate treatment. If treated within 6 hours, there is nearly a 100% chance of saving the testicle. Within 12 hours this rate decreases to 70%, within 24 hours is 20%, and after 24 hours the rate approaches 0. Once the testicle is dead it must be removed to prevent gangrenous infection.

A simple and minor surgery will correct and prevent testicular torsion. It can be done in an emergency situation after determination that the testicle is cut off from blood supply or as an outpatient procedure for patients who have experienced frequent episodes with testicular torsion. If necessary, the surgeon will first untwist the testicle(s). The surgeon will then permanently suture the testicles to the inner lining of the scrotum. If only one testicle has been problematic, the surgeon may suture both testicles as a preventative effort.