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What is a Twisted Testicle?

By M. DePietro
Updated Mar 03, 2024
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A twisted testicle, which is also called testicular torsion, occurs when the testicle rotates on the spermatic cord. One or both testis can be affected. The cord provides the blood supply to the testicle. Because the blood supply to the testicle is cut off, the tissue can die. If this occurs, male fertility can be affected.

Symptoms include sudden, severe pain. There may also be abdominal pain and nausea. The scrotum may also appear swollen, and the testicles may be higher than normal. Although a twisted testicle can occur at any age, including infancy, it is most common in adolescent males. Because immediate treatment is needed, it is considered a medical emergency.

The cause of twisted testicles is not clearly known. There appears to be a trait some males inherit, however, which allows the testicles to rotate inside the scrotum. It most commonly occurs during sleep. An injury to the testicles may also cause the condition. Once a male has this happen, he is at an increased risk of the condition happening again.

A diagnosis can often be made after a physical exam. An ultrasound may also be recommended to check for reduced blood flow to the testicle. Blood and urine tests may be ordered to rule out other conditions, which can cause pain in the testicles.

In some males, the condition will reverse itself spontaneously. Pain will subside, and the testicle becomes untwisted. Even if the testicle becomes untwisted, a doctor should still be consulted to determine if treatment is needed to prevent the condition from developing again.

If the condition has not reversed itself, surgery is the main treatment. Occasionally a physician may try manually untwisting the testicle. Surgery may still be needed to prevent the condition from developing again.

Surgery is done under anesthesia. The scrotum will be cut, and the testicle will be untwisted. If some of the tissue has died, it will need to be removed. In some cases, the entire testicle has to be removed. If the testicle is saved, it will be stitched to the wall of the scrotum to prevent the twisting from happening again.

The success rate of surgery and chance of saving the testicle depends on how quick the surgery was performed. Research indicates that if surgery is performed within the first six hours of a twisted testicle, the testicle can be saved about 90 percent of the time. The success rates drop to about 50 percent if surgery occurs after 12 hours. There is only about a 10 percent chance of saving the testicle if surgery is performed after 24 hours.

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Discussion Comments

By Greenwood250 — On Oct 08, 2019

I had a testicle hernia in my preteens. They discovered my left testicle had not dropped and it twisted. They immediately rushed me to surgery. When I woke up I had a piece of string attached to the ball sack. I am not sure why this was done. After a couple of days of recovering the string broke. Doctor wasn't very happy with me. I did it by rolling up a friend's bed. lol. I was examining myself the other day and discovered a lump on the left side but not in the sack area but on the side. It seems to be attached to a cord. I don't remember noticing this before. Question is, was my testicle attached to this string and is this my left testicle that has never fully fallen?

By anon322243 — On Feb 26, 2013

When my son was born, the doctor saw that his testicle was very swollen and blue. I can say that it looked very bad and we and the doctor didn't know what was wrong with him. At two days old he went to surgery and the doctors had to take the testicle because it was twisted and they could not save it.

The doctor says that this probably happened to him a few days before the birth. When my son turns 5 years old, he will get another surgery to put in a fake testicle.

By anon284674 — On Aug 10, 2012

Mine was twisted for two days and they saved it.

By anon260851 — On Apr 12, 2012

I had my testicle removed at 13. It happened the day before school golfing with my best friend. I was too afraid to tell my parents about it for the first two days. It hurt like hell. I could barely walk or sleep, and it was about the size of a stress ball by the second day. Could you believe that? I went to the first day of school dying in pain, pretending nothing happened. I finally got the nerve to tell my mom and I went to the doctor ASAP, then they transferred me to get an ultrasound, then surgery.

There was no way they could save, it knowing that there is a 10 percent chance of survival after 24 hours. One week later, I went on a professional snowboard TV trip to Argentina and the stitches were just starting to come out. The first time I ever ejaculated successfully was during that trip. Ever since that day I have lost tons of self confidence and I'm scared girls will find out (they haven't yet).

I've only told two people I know and I'm getting a fake one put in. I definitely think young people should be aware of this because if I had been, I wouldn't have lost it. I thought it was just growing pains and one testicle was growing faster than the other.

By anon246107 — On Feb 08, 2012

I had a history of testicular torsion which had always undone itself and was unaware of the seriousness of the condition. Unfortunately, I recently had it happen again and went to the ER too late. I had to have a testicle removed.

What confused me was I felt abdominal pain which apparently was residual pain from my ailing testicle and did not take the appropriate precautions. Know the symptoms -- swelling and discoloration of the testicle and significant pain. It is *not* a dull pain that comes with bruising.

Surgically in losing a testicle (the other one was tacked), the doctor said a 90 percent recovery takes about 90 days, but 100 percent as long as eight months. I spent a week on the couch and have slowly started walking around in a very cautious manner. The other testicle will act like a 'spare tire' and will pick up the full duties. Hormonally you should be fine, though sperm counts will be lower but not prevent fatherhood by any sort.

I'm wrapping up week two since the incident and have experienced dull soreness and some phantom pains, but otherwise have started to be able to move around more normally.

I highly encourage public awareness on this taboo topic.

By Potterspop — On May 15, 2011

If anyone reading this is worried about the effects on male fertility after losing a testicle, you can relax. My father had one removed as a young man and it had no effect on his ability to make babies.

By Valencia — On May 13, 2011

@angelBraids - I totally understand your worry, and having been through this recently I hope I can give you some useful advice and reassurance.

Your guy should get any testicle pain or swelling checked out as soon as it happens, which sounds kind of obvious but I know from my own experience that it's not always an easy thing to actually do.

My brother had his testicle removed and was told to avoid contact sports, for fear of damage to the remaining one. I wouldn't think that martial art practice would be a major problem, unless your boyfriend has the same thing happen to him.

Anyhow, I am pretty sure that groins are off limits in those sports, except for Muay Thai boxing. He could always wear some kind of guard just in case he has an accidental injury there.

By angelBraids — On May 11, 2011

My boyfriend checks his testicles for lumps on a regular basis, which is of course a good thing. Would he be able to feel something like this if it was in the early stages?

I am also a bit worried about him being hurt because he is a martial arts freak. Can anyone put my mind at rest here and tell me that a blow to the groin wouldn't bring this condition on?

By Valencia — On May 09, 2011

My younger brother has just had surgery for this problem. It's not a bad thing that twisted testicle symptoms tend to be so sudden and painful. If it was more of a slow onset I think he would have avoided telling anyone for as long as possible.

It's definitely something that pre-teen boys should be aware of I think. As it was, nobody in my family had a clue what was going on and it was pretty scary really.

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