Delayed Presentation of Testicular Torsion in a 72-Year-Old Male Patient Leading to Orchiectomy: A Case Report.

Testicular torsion is a time-sensitive urological emergency in which delays in diagnosis and treatment can lead to testicular loss. Although classically seen in adolescents, it can occur at any age, and delayed presentation significantly increases the likelihood of orchiectomy. We present the case of a 72-year-old male patient who presented with a one-week history of left hemiscrotal pain and swelling. Color Doppler ultrasonography demonstrated absent intratesticular blood flow. Urgent scrotal exploration revealed a complete 720-degree left testicular torsion with a fully necrotic testis, necessitating left orchiectomy and contralateral orchiopexy. Histopathological examination confirmed ischemic necrosis with no evidence of malignancy. This case highlights the importance of maintaining a high index of suspicion for testicular torsion in elderly patients, the role of prompt Doppler ultrasonography, and the necessity of urgent surgical exploration regardless of symptom duration.