Men are reluctant to visit their doctor but pain in the testes, associated with torsion of the testes, is one thing that brings many men to the doctor’s office. Testicular torsion requires emergency treatment.
What is testicular torsion
Testicular torsion occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum. The reduced blood flow causes sudden and often severe pain and swelling.
Testicular torsion is most common between ages 12 and 18, but it can occur at any age – even before birth.
Testicular torsion usually requires emergency surgery. If treated quickly, the testicle can usually be saved. When blood flow has been cut off for too long, a testicle might become so badly damaged that it has to be removed.
What causes torsion of the testes?
Testicular torsion occurs when the testicle rotates on the spermatic cord which brings blood to the testicle from the abdomen. If the testicle rotates several times, blood flow to it can be entirely blocked – causing damage more quickly.
It is not clear why testicular torsion occurs. Most males who get testicular torsion have an inherited trait that allows the testicle to rotate freely inside the scrotum. This inherited condition often affects both testicles. Not every male with the trait will have testicular torsion.
Testicular torsion often occurs several hours after vigorous activity, after a minor injury to the testicles, or while sleeping. Cold temperature, or rapid growth of the testicle during puberty, may also play a role.
What are some symptoms of testicular torsion?
Young boys who have testicular torsion typically wake up, in the middle of the night or early in the morning, due to scrotal pain – severe pain that develops quickly – within a few hours, often much more quickly. The pain is in the affected testis but you may also feel it in the middle of your tummy (abdomen) due to a shared nerve supply. The affected testis soon becomes tender, swollen and inflamed.
Other symptoms include the following:
• Nausea and vomiting
• Frequent urination
• Fever
Seek emergency care for sudden or severe testicle pain. Prompt treatment can prevent severe damage or loss of your testicle if you have testicular torsion.
You also need to seek prompt medical help if you have had sudden testicle pain that goes away without treatment. This can occur when a testicle twists and then untwists on its own (intermittent torsion and detorsion). Surgery is frequently needed to prevent the problem from happening again.
Get Help Right Away
Talking to someone about your private parts might seem a little embarrassing. It is really important, though, to tell a parent or contact a doctor if you have pain in your scrotum. Ignoring pain for too long, or simply hoping it goes away, can result in severe damage to your testicle and might lead to your testicle being removed.
Diagnosis
Your doctor will ask you questions to verify whether your signs and symptoms are caused by testicular torsion or something else. Doctors often diagnose testicular torsion with a physical exam of the scrotum, testicles, abdomen and groin. In a few cases other tests might be needed.
Treatment
Once the diagnosis is made urgent surgical treatment is instituted. Delaying surgery might result in loss of the testicle. If the blood supply to your testis is cut off for more than about six hours then permanent damage is likely to occur.
Complications of testicular torsion
Testicular torsion can cause the following complications:
• Damage to or death of the testicle. When testicular torsion is not treated for several hours, blocked blood flow can cause permanent damage to the testicle. If the testicle is badly damaged, it has to be surgically removed.
• Inability to father children. In some cases, damage or loss of a testicle affects a man’s ability to father children.
What Happens After Surgery?
Following surgery, males need to avoid strenuous activities (like sports) and sex, or sexual stimulation (like masturbation), for a few weeks after testicular torsion surgery. Talk to your doctor about when it will be safe to go back to your normal activities.
Males who have a testicle removed might be able to get a prosthetic, or artificial, testicle a few months after the surgery. Most men will still be able to father children later in life with one working testicle.
If you have had a testicle removed, do not despair. It is not the end of the world. Chances are you will still be able to father children and lead a perfectly normal life.
Conclusion
Testicular torsion is an emergency condition. It happens when the spermatic cord, which provides blood flow to the testicle, rotates and becomes twisted. Severe pain in the testes occurs. Testicular torsion (also called testis torsion) requires immediate surgery to save the testicle. If testicular torsion goes on for more than a few hours, it can permanently damage the testicle, and a damaged testicle must be removed. All males who suddenly develop severe pain in the testes should seek urgent medical attention.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-six years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5928).
