What is a Testicular Torsion?

Testicular torsion is an emergency medical condition in which one testicle twists around within the scrotum, thereby cutting off its blood supply. An affected testicle tends to swell and cause immediate, severe pain. The condition can potentially occur in a male of any age, but it is most likely to be seen in infancy or adolescence due to the high degree of developmental change within the reproductive system. A person who experiences testicular torsion should be evaluated and treated by emergency room personnel immediately to prevent permanent loss of testicular functioning.

A testicle receives blood and dispenses sperm through portions of a cord called the spermatic tube. When a testicle twists around, it can cause the spermatic tube to kink and consequently stop blood flow. Testicular torsion can sometimes occur due to an acute sports injury or other traumatic event, but most cases appear unexpectedly. Doctors have identified particular inheritable genes that affect the stability of the testicles, leaving some people more susceptible to testicular torsion than others.

Common symptoms of testicular torsion include localized swelling on one side of the scrotum, sharp pains, and tenderness. A person may also become lightheaded and nauseous as pain increases. It is essential to seek immediate care when experiencing sudden testicular pains to find relief symptoms and obtain the appropriate treatment.

An emergency room urologist can usually diagnose testicular torsion by asking the patient about symptoms and physically examining the scrotum. The doctor may decide to collect blood and urine samples and conduct diagnostic imaging tests to rule out other causes of testicular pain, such as an infection or tumor. After confirming a diagnosis, the urologist usually arranges for immediate surgery.

During a corrective procedure, a skilled surgeon cuts into the scrotum, identifies the area of twisting, and manually unwinds the spermatic tube. He or she then stitches, or anchors, the testicle to the wall of the scrotum to reduce the likelihood of a recurring episode. The surgeon will usually anchor the unaffected testicle during the procedure as well as a preventive measure.

When the condition is treated within about six hours of the onset of symptoms, the prognosis is typically very good. Waiting longer than six hours to receive treatment may result in permanent damage to tissue in the spermatic tube, which can lead to infertility. An untreated case of testicular torsion can cause tissue death in and around the testicle, necessitating an operation to remove it completely. Patients are usually able to return to physical activities, including sex, within three months of successful procedures.