Family Nurse Practitioner Exam

Which clinical sign is NOT typically seen early in testicular torsion?

1. Nausea and vomiting

2. Absence of the cremasteric reflex

3. Affected testicle elevated compared to the normal testicle

4. Affected testicle swollen and feeling cold to touch

The correct answer is: Affected testicle swollen and feeling cold to touch

The choice indicating that the affected testicle is swollen and feeling cold to touch is not typically observed early in testicular torsion. In the initial stages of testicular torsion, the affected testicle may be painful and elevated, but swelling and changes in temperature often occur later as the torsion persists and blood flow to the testicle is compromised. Initially, symptoms such as nausea and vomiting may be present due to visceral pain associated with the condition, which can lead to a sympathetic response in the gastrointestinal tract. The absence of the cremasteric reflex is also an important clinical finding early on, as this reflex is usually elicited when the inner thigh is stroked, causing contraction of the scrotal muscles and raising the testicle. In cases of torsion, this reflex is absent on the affected side because the blood supply is interrupted. In summary, while nausea and vomiting, the absence of the cremasteric reflex, and elevation of the affected testicle are signs typically observed early in testicular torsion, swelling and a cold sensation to the touch usually develop later as the condition progresses, making this the correct answer.