Testicular Torsion

What Is It?

Torsion of the testicle is an uncommon but serious condition in which the testicle twists on the cord that provides its blood supply. The twisting of this cord cuts off the blood supply to the testicle. It is extremely painful and must be treated immediately to prevent permanent damage to the testicle. Testicular torsion can happen after strenuous exercise or an injury, but it also can occur without any apparent cause. The condition can occur at any age but is most common between the ages of 10 and 20.

Symptoms

Sudden onset of severe pain and extreme tenderness in one testicle, with or without an obvious cause, is the most striking symptom. Other symptoms include nausea and vomiting associated with the pain, and swelling on one side of the scrotum.

Diagnosis

The diagnosis is based largely on the symptoms described above and a physical examination. The testicle may be raised high in the scrotum on the affected side. Your doctor will try to make sure the symptoms aren't caused by other conditions that affect the testicle and scrotum, including epididymitis (inflammation of the cord-like seminal duct, located behind the testicle) and orchitis (inflammation of the testicle itself, often caused by infection). An ultrasound test to examine the contents of the scrotum may help sort out the cause. Sometimes, surgery is necessary to make a definite diagnosis. It's important for the condition to be diagnosed rapidly to ensure the best outcome.

Expected Duration

Occasionally, the testicle may untwist on its own, causing immediate relief from the swelling and pain. However, immediate medical attention is essential. Do not wait for the testicle to untwist on its own. Testicular torsion must be treated within a few hours to prevent permanent damage.

Prevention

Most cases of testicular torsion cannot be prevented.

Treatment

This condition is a surgical emergency. Sometimes, a urologist (a doctor who specializes in illnesses of the urinary tract and male reproductive organs) will attempt to untwist the testicle by hand. If this is not successful, immediate surgery is needed to save the testicle. An incision is made in the scrotum so that the cord can be untwisted and the testicle anchored in place with a couple of stitches. If the testicle has been damaged by an absence of blood flow, it may have to be removed. The unaffected testicle also may be anchored during surgery to prevent it from twisting in the future.

When To Call A Professional

Most people with testicular torsion will need to be evaluated in an emergency room. Seek medical attention for severe pain on one side of the scrotum that persists for more than a few minutes, especially if it is associated with swelling, nausea and vomiting.

Prognosis

The testicle will recover quickly and completely if the condition is corrected immediately. If the blood supply to the testicle is cut off for a prolonged period, the testicle may need to be removed surgically. Most men who have had testicular torsion will have normal fertility and sexual function.

Additional Info

American Academy of Family Physicians (AAFP)

11400 Tomahawk Creek Parkway

Leawood, KS 66211-2672

Phone: (913) 906-6000

Toll-Free: (800) 274-2237

E-Mail: email@familydoctor.org

http://www.familydoctor.org/

American Urological Association

1000 Corporate Blvd.

Linthicum, MD 21090

Phone: (410) 689-3700

Toll-Free: (866) 746-4282

Fax: (410) 689-3800

E-Mail: aua@auanet.org

http://www.urologyhealth.org/