Testicular Torsion

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It is critical to take any strong pain in your penis or testicles seriously. Testicular torsion or “twisting of the testes” is rare (1 out of 4000 guys’ under the age of 25 per year) but it is important for boys/young men to know about it because surgical treatments are needed right away to save the testes. Without surgery within a few hours of the pain starting, the testicle doesn’t get enough blood to survive and may need to be removed. There are also problems (like infections) which can cause pain around the penis, which a doctor may need to treat, so it’s important to get checked out if you are at all concerned.

In most guys, the testicles are correctly attached to the scrotum (the sac below the penis). The risk of testicular torsion is higher in boys/young men who have a rare condition (“bell clapper” deformity) in which the testicles aren’t correctly attached to the scrotum. Read on to learn more about this rare, but serious condition.

What is testicular torsion?

Testicular torsion is a medical condition that can occur in males. It occurs most commonly in boys and young men between the ages of 12-18, but can also occur before birth, or later in life. What happens with testicular torsion is that the spermatic cord rotates and cuts off blood flow to the testicle. Without blood floow the testis will eventually die.

Is testicular torsion a serious condition?

Yes. Testicular torsion is a serious condition, and needs to be fixed as quickly as possible. If blood flow isn’t restored to the testicle within approximately 6 hours, the testicle can die. In fact, the most common cause of testicle loss with testicular torsion is delay in treatment.

What are the symptoms of testicular torsion?

Symptoms of testicular torsion include:

  • *Pain in the testicle
  • Pain in the lower abdomen (lower belly area)
  • Nausea
  • Vomiting

*The testicular pain associated with torsion is usually severe and comes on suddenly.

What should I do if I think I have testicular torsion?

If you think you have testicular torsion or have pain in your testes or groin, call your health care provider immediately. He or she will likely recommend that you go to the emergency room, because this is a serious condition that needs treatment right away. If you cannot reach your health care provider immediately, go to the emergency room as soon as possible.

How is testicular torsion diagnosed?

To diagnose testicular torsion, a health care provider (HCP) will perform a clinical exam; this means that he or she will ask you about your symptoms and look at your testicle for any signs of swelling or redness. The HCP will likely test your reflexes by lightly pinching or rubbing the inside of your thigh. Doing this usually makes the testicle contract, but if you have testicular torsion this may not happen. He or she may also send you for an ultrasound, a painless test that uses sound waves (no radiation) to take pictures of the inside of your body. An ultrasound will show whether or not the blood is flowing correctly to your testicle.

How is testicular torsion treated?

If your health care provider determines that you have testicular torsion, you will need to have surgery right away.

  • During the operation, the surgeon will untwist your testicle and check to see if it can be saved. If it can, he or she will place stitches around both testicles to repair the twisted one and to prevent torsion from happening to the other testicle.
  • If your surgeon determines that your testicle can’t be saved, he or she will remove your testicle, and place stitches around the other one to prevent future torsion.
Remember: The quicker you’re treated, the better the chances are that the surgeons will be able to save your testicle.

What can I expect after surgery?

After surgery, you won’t feel the stitches, but you’ll have some discomfort. Your surgeon will likely prescribe some pain medicine for you to take for a few days. You’ll be able to go back to school within a few days to a week, but will be asked to avoid strenuous exercise and playing sports for a few weeks.

Is there anything I can do to prevent testicular torsion?

Unfortunately, there isn’t anything you can do to prevent testicular torsion from happening. However, it’s always a good idea to wear proper protection when playing sports to avoid any kind of testicular injury. If you’ve already had surgery for testicular torsion, the stitches placed inside you will help prevent future torsion from happening.