Testicular Torsion

Testicular torsion is a twisting of the spermatic cord, artery, and vein that go to the testicle. This twisting cuts off the blood supply to everything in the sac that contains the testes, blood vessels, and part of the spermatic cord (scrotum). Testicular torsion is most commonly seen in newborn and adolescent males. It can also occur before birth.

ExitCare ImageTesticular torsion requires emergency treatment. The testicle usually can be saved if the torsion is treated within 6 hours of onset. If the torsion is left untreated for too long, the testicle will die and have to be removed.

CAUSES

Torsion can be caused by a hit on the scrotum or by certain movements during exercise. In some males, testicular torsion is more common because the connection of their testicle to a specific tissue in their scrotum developed in the wrong place, allowing the testicle to rotate and the cord to get twisted.

SIGNS AND SYMPTOMS

The main symptom of testicular torsion is pain in your testicle. The scrotum may be swollen, red, hard, and very tender. There will be excess fluid in the tissue (edema). The testicle may be higher than normal in the scrotum. The skin of the scrotum may be stuck to the testicle. You may have nausea, vomiting, and a fever.

DIAGNOSIS

Often testicular torsion is diagnosed through a physical exam. Sometimes imaging exams and tests to measure blood flow may be done.

TREATMENT

A manual untwisting of the testicle may be done when the testicle is still mobile and the maneuver is not too painful. However, surgery usually is necessary and should be done as soon as possible after torsion occurs. During surgery, the testicle is untwisted and evaluated and possibly removed.