Testicular Torsion – Symptoms and Causes
Twisting of the testicle happens when a testicle rotates, causing the spermatic cord to twist. This cord brings blood to the scrotum, which is the skin sac that holds the testicles.
When blood flow is reduced, it causes sudden pain and swelling. This problem is most common in boys between 12 and 18 years old. However, it can happen at any age, even before a baby is born.
This condition requires emergency medical help. If doctors treat it quickly, they can usually save the testicle. But if blood flow is cut off for too long, the testicle may become damaged beyond repair and need to be removed.
Symptoms
Testicular torsion often starts with sudden, intense pain in the scrotum, which is the skin sac that holds the testicles. The scrotum may become swollen. Some people also feel pain in their abdomen.
Other common symptoms include:
- Feeling sick to the stomach (nausea)
- Throwing up (vomiting)
- Testicle sitting higher or at an odd angle
- Needing to urinate more often
- Rising body temperature (fever)
Boys who experience testicular torsion typically wake up with scrotal pain during the night or in the early morning hours.
When to See a Doctor
Get emergency medical help for any sudden or severe pain in your testicles. Quick treatment is essential to prevent serious damage or loss of the testicle if you have testicular torsion.
You should also seek immediate medical care if you experience sudden testicular pain that disappears on its own. This may indicate intermittent torsion and detorsion, where the testicle twists and then untwists naturally.
Even if the pain stops, surgery is often necessary to prevent this dangerous condition from recurring.
Important warning signs that require urgent medical attention:
- Sudden, severe testicular pain
- Testicular pain with swelling
- Pain that comes and goes without treatment
Causes
Testicular torsion happens when a testicle twists around the spermatic cord. This cord carries blood from the abdomen to the testicle. When the testicle twists multiple times, blood flow gets cut off completely, which can quickly damage the testicle.
Doctors aren’t entirely sure why testicular torsion occurs. Many males who experience this condition have a genetic trait that allows their testicles to rotate freely in the scrotum.
While this trait often affects both testicles, not everyone with it will develop testicular torsion.
Several factors may trigger testicular torsion:
- Vigorous physical activity (often occurs hours after).
- Minor testicular injuries.
- Sleep (can happen during rest).
- Cold temperatures.
- Rapid growth during puberty.
The condition can appear suddenly and requires immediate medical attention to prevent permanent damage.
Risk Factors
Several factors may increase the chance of testicular torsion:
- Age Range: This condition most commonly affects boys and young men between 12 and 18 years old.
- Previous Episodes: If you’ve had testicular pain that went away without treatment, it might have been temporary torsion that resolved itself. These episodes tend to recur, and frequent occurrences raise the risk of permanent damage.
- Genetic Component: Testicular torsion can run in families, suggesting a hereditary factor in some cases.
Complications
Testicular torsion can lead to serious problems if not treated quickly.
- Testicle Damage or Loss: When blood flow is blocked for several hours, the testicle tissue can die. If damage is severe, doctors may need to surgically remove the testicle.
- Fertility Issues: Losing a testicle or having testicle damage might affect a man’s ability to have children. The remaining testicle can usually produce enough sperm, but in some cases fertility may be reduced.
Prevention
Some males inherit a condition where their testicles can freely rotate within the scrotum. This natural characteristic increases the risk of testicular torsion.
For those with this trait, the only effective prevention method is a surgical procedure. During this operation, doctors permanently attach both testicles to the inside wall of the scrotum, preventing them from twisting.
