Testicular torsion is an emergency. It occurs when a testicle rotates, twisting the spermatic cord and reducing blood flow, leading to severe pain and swelling. This condition requires immediate assessment and management, as if not treated promptly, surgery may be needed to remove the affected testicle. Testicular torsion primarily affects one testicle, with the left one being more commonly affected.
Causes
Testicular torsion is quite rare. Only one in 4,000 men under age 25 are reported to have symptoms of torsion. It happens spontaneously and its exact cause is not yet clear, however it reportedly occurs more after vigorous activity, minor injury to the genitalia, or during sleep.
Most cases occur in people with a bell clapper deformity, where the testicles hang freely in the scrotum. Testicular torsion can also occur after a direct injury to the testicle or scrotum.
Symptoms
Testicular torsion typically manifests as sudden, severe pain in the testicles that can occasionally spread to the stomach or cause nausea. One might find it so excruciating that walking becomes difficult. In others, the pain may initially subside and then return worse.
Signs and symptoms of testicular torsion you may notice include:
- Sudden, severe pain in the scrotum
- A visible swelling on a testicle
- Discolouration (red, purple, brown, black) of your scrotum.
- Nausea and vomiting
- Abdominal pain
- Fever
- Frequent urination
Risk factors
Testicular torsion is most common between ages 12 and 18. Testicular pain, such as intermittent torsion and detorsion, is likely to recur if it has previously disappeared without medical intervention. Testicular damage is also more likely in cases where pain episodes occur more frequently.
Additionally, if there is a history of testicular torsion in the biological family, one may be at higher risk of developing Testicular torsion too. Major risks are;
- Age between 12- 18
- Previous testicular torsion
- Family history of testicular torsion
Complications
Without blood flow, the testicles can only endure for roughly six hours. A surgeon will have to remove the testicle from the scrotum if it dies. Research indicates that one in three (1-in-3) individuals experience a decrease in sperm count following Testicular torsion. Chances of having biological children may also be impacted by the lower sperm count. The major complications are;
- Permanent damage to the testicles
- Male infertility
Management
Generally, the testicle can be saved if it is treated promptly. For someone who has Testicular torsion, they may require emergency surgery called an orchiopexy, in which a surgeon will untwist the testicle to restore blood flow to the affected area. Occasionally, they may need to make a tiny incision through the groin.
Both testicles are typically affected by torsion in individuals with bell clapper deformity. In this case, the inner scrotal wall will be stitched to the unaffected testicle by a surgeon. However, prolonged interruption of blood supply can cause testicular damage to the point where removal is necessary.
Prevention
Some males are born with the condition that cause their testicles to rotate within the scrotum known as bell clapper deformity. Surgery to join both testicles to the inside of the scrotum is the only treatment available if there is this characteristic, to avoid Testicular torsion.
