Testicular Torsion

What is Testicular Torsion?

Testicular torsion is a rare condition that causes a twisting of the reproductive organ that produces sperm and male hormones. The testicle rotates in such a way that the cord supplying blood from the abdomen to the scrotum becomes twisted. The more it is twisted, the more quickly damage can occur. The condition may manifest after injury to the testicles, vigorous activity, or even after sleep.

It is currently not known why testicular torsion happens. It does appear that males who experience it inherit a trait that lets the testicles maneuver freely within the scrotum. However, not all males with the trait will develop testicular torsion. It is possible that cold temperatures and fast testicle growth during puberty might also play a part. The condition is most often seen in teenagers who have had a previous occurrence or a family history of testicular torsion.

What are the Symptoms of Testicular Torsion?

Testicular torsion is characterized by a sudden and severe swelling and pain in the testicles. Patients may also notice that one testicle is sitting higher than the other or at an abnormal angle. Additionally, symptoms often include:

  • Nausea
  • Vomiting
  • Abdominal pain
  • Fever
  • Painful urination

Testicular Torsion Causes

Testicular torsion occurs when the spermatic cord, which carries blood from the abdomen to the testicle, rotates. Usually this occurs because the testicles are not well attached within the scrotum via other tissues, which means they are able to move around relatively easily. This is known as a “bell-clapper” deformity.

The deformity, which is usually an inherited trait, doesn’t always lead to testicular torsion in every man that has it. It’s also not clear exactly what triggers the torsion. Sometimes it occurs some hours after vigorous activity, such as sports, or if the testicles have sustained a minor injury. However, in many cases it seems to occur at random.

It is thought that testicular torsion could be linked with rapid growth of the testicles during puberty. There is also some evidence to suggest that exposure to the cold could be related to the condition in some way.

How is Testicular Torsion Treated?

Testicular torsion is a condition that requires immediate emergency medical care when it sets in suddenly with severe pain. Many cases require surgical repair in order to correct the twisting. While a doctor may be able to push on the scrotum to put the testicle back in place, surgery will still be needed to stop it from happening again. To do this, the testicles will be stitched to the inside of the scrotum. The sooner the surgery takes place, the better. The general consensus is to have it done within six hours of symptom onset to improve the chances of saving the testicle. If more than 48 hours pass, the chances of needing to have the affected testicle removed jumps to 90 percent.

Testicular Torsion Prevention

Individuals with the “bell-clapper” deformity may choose to prevent testicular torsion with surgery. It may be possible to attach the testicles to the inside of the scrotum to prevent them from rotating. However, many men remain completely unaware that they have the condition unless they develop testicular torsion. Usually, when testicular torsion occurs in one testicle, surgery is performed to prevent it occurring in the other.

To prevent the risk of having a testicle completely removed after testicular torsion, which is a possibility in severe cases if blood supply has been cut off for too long, rapid treatment is necessary. Learn about the signs and symptoms of testicular torsion, keep an eye out for swelling of the scrotum or changes to the height of the testicles, and always consult emergency care if you experience acute testicular pain.

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Last Reviewed:
October 11, 2016
Last Updated:
March 30, 2018