Testicular torsion is a serious condition in which blood flow to the testicle is cut off. This condition requires immediate treatment. If the blood supply is not returned to the testis quickly (within six hours), the testis can be surgically removed. You can find more information below.
What is testicular torsion?
Testicular torsion is a condition in which the blood supply in a man’s testicles (spermatic cord) is twisted and blood flow to the testicles is cut off. The reduction and interruption of blood flow often causes sudden severe pain and swelling.
This condition often requires emergency surgery. If treated quickly, the testicle can usually be saved. But when blood flow is cut off for too long, a testicle can be badly damaged and must be removed.
Who is it seen in?
Testicular torsion is a rare but very serious condition. It affects about one in 4000 men under the age of 25. It is most common in adolescents aged 12 to 18 years, accounting for 65 percent of all cases. It can also affect newborn babies in the first year of life. This condition, although rare, can also affect men over the age of 25 and is usually a spontaneous event.
What causes testicular torsion?
Testicular torsion occurs when the testicle is twisted or rotated, which cuts off blood flow to the testicles. If the testicle rotates several times, the blood flow may be completely blocked, causing damage more quickly.
It is not clear why this problem occurs. Most men who get this condition have an inherited trait that allows the testicles to rotate freely within the scrotum (the loose bag of skin under your penis that contains the testicles) . This inherited condition often affects both testicles. However, there is no rule that every man with a hereditary condition will get it.
It usually occurs a few hours after vigorous activity, after a minor injury to the testicles, or while sleeping. Sudden temperature changes such as cold-temperature during adolescence or rapid growth of the testis may also play a role.
Who is at risk?
Risk factors include:
- Age: This condition is most common between the ages of 12 and 18.
- Previous testicular problems: If you have untreated testicular pain, it will likely come back. The more frequent episodes of pain occur, the higher the risk of testicular damage.
- Genetic predisposition: Having someone else in the family with the same condition is also a risk factor.
What are the symptoms of testicular torsion?
Symptoms of testicular torsion include:
- Sudden, severe pain in and around the testis
- Swelling in and around the testicle
- Stomach ache
- Nausea and vomiting
- Testicle higher than normal or at an unusual angle
- the need to urinate frequently
Young men with this problem often wake up in the middle of the night or early in the morning with scrotal pain.
When should you see a doctor?
You should seek emergency help for sudden or severe testicular pain. If you have testicular torsion, prompt treatment can prevent serious damage or loss of the testicle.
You should also seek immediate medical attention if you have sudden testicular pain that goes away without treatment. This can happen if a testicle flexes and then opens on its own. Surgery is often needed to prevent the problem from happening again.
How is testicular torsion diagnosed?
Your doctor will ask you questions to confirm that your symptoms are due to testicular torsion or something else. Doctors usually diagnose testicular torsion by physical examination of the scrotum, testicles, abdomen, and groin.
Your doctor may also test your reflexes by gently rubbing or pinching the inside of your thigh on the affected side. Normally, this causes the testicle to contract. If there is testicular torsion, this reflex may not occur.
Sometimes medical tests may be needed to confirm a diagnosis or help identify another cause for your symptoms. E.g:
- Urinalysis: This test is used to check for infection.
- Scrotal ultrasound: This type of ultrasound is used to check blood flow. Reduced blood flow to the testis is a sign of testicular torsion. However, ultrasound does not always detect decreased blood flow, so this test may not rule out testicular torsion.
- Surgery: Surgery may be needed to determine if your symptoms are due to testicular torsion or another condition.
If you have pain for several hours and your physical examination shows testicular torsion, you may be taken straight into surgery without any additional testing. Because delaying the surgery may cause testicular loss.
How is testicular torsion treated?
Surgery is required to treat this problem . In some cases, the doctor may open the testicles by pushing the scrotum ( manual detorsion ). But you still need to have surgery to prevent the torsion from recurring.
Surgery for torsion is usually done under general anesthesia. During surgery, your doctor will make a small cut in your scrotum, open your spermatic cord if necessary, and sew one or both testicles into the scrotum.
The sooner the testicle opens, the greater the chance of recovery. Six hours after the onset of pain, the chance of needing testicle removal increases greatly. If treatment is delayed by more than 12 hours from the onset of pain, there is at least a 75% probability that the testis will need to be removed.
Treatment in newborns and infants
Testicular torsion can occur in newborns and infants, but is rare. The baby’s testicle may be hard, swollen, or a darker color. Ultrasound may not detect decreased blood flow to the baby’s scrotum, so surgery may be needed to confirm the diagnosis.
Treatment in infants is controversial. If a child is born with signs of testicular torsion, it may be too late for surgery and there are risks associated with general anesthesia. However, emergency surgery can sometimes save all or part of the testicle and prevent the same condition from occurring in the other testicle. In infants, treatment can prevent future problems with male hormone production and fertility.