Testicular torsion

Testicular torsion is when the spermatic cord twists, cutting off the blood supply and causing severe pain and swelling.

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Medically reviewed by

Dr Gideon Blecher

What is testicular torsion?

Testicular torsion is a twisting of the spermatic cord within the scrotum that reduces, or completely stops, blood flow to the testis (testicle).

Testicular torsion is a medical emergency and requires immediate treatment.

Testicular torsion is most likely to happen in newborn or adolescent males, affecting around 1 in 22,000 to 1 in 33,000 males aged under 25 years each year. About 60% of cases of testicular torsion occur in boys aged 12-18 years.

Symptoms of testicular torsion

Testicular torsion causes severe pain, usually in the scrotum, that starts suddenly. In many cases, it causes pain in the abdomen, and can cause nausea and vomiting.

The affected testicle might be in a different position or higher in the scrotum than normal. It’s usually slightly swollen and sore to touch.

Causes of testicular torsion

Testicular torsion occurs when the testicle rotates within the scrotum.

Usually, a connective tissue called the tunica vaginalis prevents the testicle from rotating. However, in some people, attachment of the tunica vaginalis allows the testicle to rotate, which can lead to testicular torsion.

Rotation of the testicle can also occur during vigorous activity or because of traumatic injury.

Diagnosis of testicular torsion

Testicular torsion is diagnosed based on a person’s symptoms, medical history and an examination. To confirm testicular torsion, an ultrasound examination of the scrotal contents will be performed to observe blood flow to the testes (testicles).

Treatment of testicular torsion

Testicular torsion requires immediate surgery to correct the problem. The longer testicular torsion lasts, the greater the chance that the lack of blood flow will cause irreversible damage.

Health effects of testicular torsion

If testicular torsion is reversed quickly, irreversible damage to the testicle can be prevented. Surgery to reverse testicular torsion includes placement of stitches to hold the testicle in place, which may also be done for the other testicle.

What to do about testicular torsion

If you have sudden onset pain in the scrotum, seek medical help immediately.

Testicular torsion

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