Testicular Torsion

What is testicular torsion?

Testicular torsion describes a condition in which the testicle becomes twisted in the scrotum. This causes the blood supply to the testicle to become blocked, and is an emergency because the testicle can die due to a lack of oxygen. Newborns, children and adolescents are most commonly affected. The most common symptom is sudden groin pain, often accompanied by nausea and vomiting. The diagnosis may be based on an ultrasound of the scrotum. The treatment is surgery to untwist the testicle and to re-position it in the scrotum. Surgery should take place as soon as possible to prevent damage to the testicle. With early diagnosis and surgery, most people recover very well.

Risks

The testicles are usually fixed in the scrotum (the muscular sac which hangs below the penis) from above and behind. In some cases the testicle does not become fixed, and twisting becomes possible. Twisting of the testicle blocks the blood vessels to the testicle, which causes the symptoms and can possibly cause death of the testicle. The cause of the twist is not known in many cases, but it can occur following scrotal surgery or an injury to the scrotum. This condition is most common before 2 years of age and between 12 and 18 years of age.

Symptoms

The most common symptom is sudden groin and scrotum pain. This may be accompanied by nausea and vomiting. In some cases, the scrotum may become red and swollen.

Diagnosis

The diagnosis is often suspected based on the symptoms and appearance of the scrotum. The diagnosis is usually confirmed with an ultrasound scan or, very commonly, during emergency surgery. Urine and blood tests may also be done to exclude any other cause for the symptoms.

Treatment

Treatment is a surgical procedure to untwist the testicle and fix it to the scrotum. If the testicle has been severely damaged, it will be removed.

Prevention

Although it is not possible to prevent testicular torsion, good surgical management can prevent the testicle from becoming twisted again.