Testicular Torsion: Symptoms & Getting Treated

What is testicular torsion

Testicles are the male reproductive organs. Usually, there are two, located in the scrotum. The testicles produce sperm. And hormones like testosterone. When one of the testicles twists onto itself, it can lead to testicular torsion. It is a medical emergency.

Twisting can reduce blood flow to the testicle. And cause damage to the organ. It's even possible to become infertile. (Unable to have a child through sexual intercourse.)

If you think you may have a testicular torsion, get emergency care right away. You may need surgery to save the testicle.

Main symptom

Scrotum or groin pain that's usually on one side.

Other symptoms of testicular torsion

• Abdominal pain. Generally around the lower part of the abdomen.
• Nausea and vomiting in waves or feel constant—or even not at all.
• The scrotum is red or swollen—or both.
• Difficulty or pain when urinating.
• Fever, though not as common.
• One testicle seems higher than the other one.

Is testicular torsion painful?

Typically, there is sudden severe pain in the scrotum. Or lower abdominal pain on the side of the affected testicle. Sometimes, nausea and vomiting accompany the pain. You may also notice the scrotum appears abnormal, such as swollen, red, or bruised.

Adults usually describe it as scrotal pain. The pain may be constant or come and go. It can be severe enough to wake them up from their sleep.

Testicular torsion causes

Differences in how the scrotum develops may play a role.

Some activities may change the length of the testicle. Compression may increase risk. But the reason the torsion occurs is, for the most part, unknown.

• Genetic risk factors. There may be a higher risk of testicular torsion if another family member has had it.
• Environmental factors. You may be more likely to experience testicular torsion in cold weather, during physical activities like cycling, or after getting hit in that area.

Testicular torsion in children

Younger children or toddlers may not be able to pinpoint the location of the pain. Or they may be afraid to mention changes in their genital region. Always get medical attention for sudden abdominal pain symptoms.

Next steps

If you have sudden or severe testicular pain, immediately go to the emergency room. Or if you notice unusual testicular changes.

Also, head to the ER if your child is experiencing sudden or severe abdominal pain. You want to get a diagnosis as quickly as possible.

How common is testicular torsion?

Testicular torsion is most common in newborns and during puberty (generally ages 13 to 16). As the anatomy—the structure of the body—changes with age, the reasons for torsion may vary. However, these causes are not well understood.

When a newborn develops, the testicles should descend (move down). They then attach to the inner wall of the scrotum. Sometimes, they do not attach properly or entirely. The spermatic cord—which connects the testicles to the abdomen—may then twist onto itself. The twisting can interfere with the blood supply and damage nerves.

Sometimes during the pre-teen and teen years, testicles rotate, move around, or twist. It may be because the testicles aren't attached to the inner scrotum wall in the right location or in the correct way.

Activities involving straddling, like cycling, may play a role too. (Straddling is when legs are wide apart.) A direct hit to the area can affect the anchoring of the testicles. It can also shift the testicles. Both can lead to torsion.

Cold weather may be another factor. Low temperatures may cause muscles surrounding the testicle and spermatic cord to contract in an unusual way.

Testicular torsion treatment

To diagnose testicular torsion, a doctor (often a urologist) evaluate the groin and scrotum area. The doctor will also check the abdomen.

You may need an ultrasound to confirm the diagnosis. (An ultrasound creates an image with soundwaves). It allows the doctor to monitor blood flow and look for twisting. An ultrasound can confirm a testicular torsion. Though sometimes, a doctor may be able to diagnose based on the signs and symptoms and an exam.

Prevent permanent damage by getting treatment as soon as possible. The urologist may try manual techniques—using their hands—to untwist the testicle. But the primary treatment involves surgery.

Ask your doctor about scrotal support. It's a sling that relieves pressure from hanging testicles.

Acetaminophen and ibuprofen or more potent prescribed drugs can lessen pain. Currently, there aren't any specific medications to treat it.

Surgery

The surgery usually involves opening the scrotum and untwisting the testicle and spermatic cord.

If the injury is severe, the testicle will be surgically removed. This procedure is called an "orchiectomy."

Otherwise, the urologist will do a procedure called an "orchiopexy." It is surgery to attach the testicles, both the injured and the healthy ones, to the inner scrotum. It helps prevent torsion from happening again.