Testicular Torsion

What is testicular torsion?

Testicular torsion occurs when the spermatic cord twists, cutting off blood flow to the testicle. It is a true emergency because delayed treatment can lead to permanent damage or loss of the testicle. ^[1][2][3]

Symptoms and emergency signs

Typical symptoms include sudden severe testicular pain, scrotal swelling, nausea, vomiting, abdominal pain, and a testicle that sits higher than usual. The pain can begin during activity, during sleep, or for no obvious reason. Because the condition is time-sensitive, sudden scrotal pain should never be ignored. ^[1][2]

What causes it and who gets it more often?

Torsion is more common in adolescents, but it can occur at other ages as well. An anatomic predisposition may increase risk. Sometimes symptoms occur intermittently if the testicle twists and untwists temporarily, but this still requires assessment. ^[1][2][3]

How is it diagnosed?

Diagnosis is based on the symptoms, examination, and sometimes scrotal ultrasound. However, if the clinical suspicion is high, treatment should not be delayed waiting for testing. Time is a critical factor. ^[1][2][3]

How is it treated?

Treatment is surgical. The goal is to untwist the cord and secure the testicle to prevent recurrence. The other testicle is often fixed as well because the same predisposition may exist on both sides. ^[1][3]

Recovery and when to return for reassessment

Recovery depends on how quickly blood flow was restored. Ongoing pain, swelling, fever, or new scrotal symptoms after treatment should be reassessed. ^[1][2]