Testicular Torsion

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KEY POINTS

• Testicular torsion is when the testicle twists in the scrotum reducing the blood flow to the testicle. The testicles and scrotum are part of the male reproductive organs.
• The testicle needs to be untwisted within 6 to 8 hours to restore blood flow to the testicle. You will need surgery even if the emergency healthcare provider is able to untwist the testicle.
• Follow the full course of treatment prescribed by your healthcare provider. Ask if there are activities you should avoid and when you can return to your normal activities.

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What is testicular torsion?

Testicular torsion is when the testicle twists in the scrotum, which reduces the blood flow to the testicle. The testicles are in a sac of loose skin, called the scrotum or scrotal sac, which is below and behind the penis. The testicles and scrotum are part of the male reproductive organs.

Testicular torsion is more common on the left side. It is a medical emergency and needs to be treated right away.

What is the cause?

The testicle can twist if the spermatic cord, which holds the testicle in place, is too long. When the testicle twists, it causes the spermatic cord and blood vessels to twist. The twist causes reduced blood to the area, and the testicle can be damaged badly unless you get quick treatment.

The twisting can happen while exercising, sleeping, masturbating, having sexual activity, standing, or walking.

What are the symptoms?

The most common symptom is sudden pain and swelling on one side of the scrotum.

Symptoms may also include:

• Nausea and vomiting
• Scrotal redness, bruising, or hardness especially on one side
• Unusual irregular shape to the scrotum
• Abdominal pain

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Ultrasound, which uses sound waves to show pictures of and blood flow to the testicles
• Urine tests to check for infection
• Blood tests

How is it treated?

If you have symptoms of a testicular torsion, you need care right away at an emergency facility. The testicle and spermatic cord need to be untwisted within 6 to 8 hours to restore blood flow to the testicle and prevent permanent damage.

You will need surgery even if the emergency healthcare provider is able to untwist the testicle.

• Your healthcare provider will make a cut in your scrotum or in your abdomen to repair the torsion.
• Your healthcare provider will untwist the testicle and cord and add stitches to keep the testicle from twisting again.
• If the testicle is damaged beyond repair from lack of blood or infection, it will be removed during surgery.
• Your healthcare provider will check your other testicle also. Your healthcare provider will use stitches to hold the other testicle in place to prevent it from twisting.

How can I take care of myself?

• Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup.

How can I take care of my child?