What is testicular torsion?
Testicular torsion occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum. The reduced blood flow causes sudden and often severe pain and swelling.
Testicular torsion is most common between ages 12 and 18, but it can occur at any age, even before birth.
Testicular torsion usually requires emergency surgery. If treated quickly, the testicle can usually be saved. But when blood flow has been cut off for too long, a testicle might become so badly damaged that it has to be removed.
Signs and symptoms of testicular torsion include:
- Sudden, severe pain in the scrotum — the loose bag of skin under your penis that contains the testicles
- Swelling of the scrotum
- Abdominal pain
- Nausea and vomiting
- A testicle that’s positioned higher than normal or at an unusual angle
- Frequent urination
Young boys who have testicular torsion typically wake up due to scrotal pain in the middle of the night or early in the morning.
The man may also notice that one testicle is positioned higher than normal or at an odd angle. The affected testicle may become larger, and it may become red or dark in colour.
Symptoms usually appear suddenly, although in some cases, the torsion can develop over a few days.
Rajiv Mehta (name changed), he experienced sharp pain in his scrotum, his testicles had turned black, they was no blood circulation to the testes. He immediately rushed to the hospital, where a doctor diagnosed him with strangulation of the testes (testicular torsion). Doctors began prompt treatment on him and early treatment helped save his testicles
My Medical Mantra spoke to a few doctors to gain a deeper understanding of this condition.
Dr Sandeep Sonawane, a general physician from Mumbai, said, “Testicular torsion occurs when the spermatic cord twist and affects the blood supply to the testes. When this happens, the person will experience excruciating pain. If treatment is delayed then it can lead to gangrene of one of the testicles. Immediate surgical intervention is needed and the testicle needs to be repositioned. The cause behind this is unknown, it can be caused due to heavy weightlifting. It is not very common and it can happen to any man.”
The majority of cases, if treated within 6 hours, do not require the removal of the testicle (orchiectomy). However, if treatment is delayed for 48 hours, the majority of patients do need to have the affected testicle removed.
Rarely, torsion happens on both sides, but only in around 2 out of every 100. If a testicle is removed, it does not mean that a man cannot have children. The remaining testicle will still produce sufficient sperm to conceive. However, low sperm count has been observed in men who have undergone a torsion.
While Dr Prakash Kothari, a senior sexologist from Mumbai, informed, “A person will undergo severe pain when he faces testicular torsion. The torsion needs to immediately relieved or it will lead to lack of blood supply to the testes and the testes will atrophy. The patient should immediately see a doctor, otherwise he will lose the testicle. If this happens, the patient need not worry as he can still father a child with one testicle.”
He added, “Surgical intervention depends on the severity of the torsion. Sonography is required to assess the extent of the damage. A general physician can relieve the pain, but only a urologist or general surgeon can address the root of the problem.”