[A CASE OF TESTICULAR TORSION TREATED WITH TUNICA ALBUGINEA FASCIOTOMY AND TUNICA VAGINALIS FLAP REPAIR].

A 37-year-old man presented with sudden right lower abdominal pain that began upon awakening and progressively worsened. He visited the emergency department 4 hours after symptom onset. Ultrasonography showed absent blood flow in the right testis, and testicular torsion was diagnosed. Emergency surgery was performed 5.5 hours after symptom onset under general anesthesia. Intraoperatively, the spermatic cord was twisted 720°. After detorsion, the testis remained dark red without improvement in color, and marked tunica albuginea tension was observed. Tunica albuginea incision was performed, resulting in immediate color improvement, and the defect was reconstructed using a tunica vaginalis flap. Semen analysis had been performed as part of infertility evaluation, and no deterioration in semen parameters was observed before and after surgery. At 6 months postoperatively, no testicular atrophy or difference in blood flow between the testes was observed. Pregnancy was confirmed 18 months after surgery.