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Testicular Torsion


Disease: Testicular Torsion Testicular Torsion
Category: Genito-urinary diseases

Disease Definition:

The spermatic cord provides blood flow to the testicle. When a testicle rotates on this cord, a condition called testicular torsion occurs, causing intense pain and swelling. Although males at all ages, even infants and newborns, are susceptible to testicular torsion, but its risks are higher in those below the age of 25.


Emergency treatment is needed in the case of testicular torsion, because early treatment might save the testicle since the longer one waits, the greater the risks become to damage the testicle and have fertility problems. Within 12 hours of testicular torsion, and unless treated, the testicle may be badly damaged and may have to be removed. Surgical operation can prevent the recurrence of the testicular torsion, but sometimes, a physician is capable of untwisting it without surgery.

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Symptoms, Causes


Some of the signs symptoms of testicular torsion are:


  • Sever and sudden pain in either of the testicles
  • Scrotum swelling
  • Vomiting and nausea
  • Pain in the abdomen
  • Fever


Some of the other symptoms of this condition might be:


  • Abnormal testicle location (height or angle)
  • An untreated testicular pain that goes away by itself, a condition called intermittent torsion and detorsion.


Blood flow difficulty can result when a testicle has rotated on the spermatic cord. This difficulty is proportional to the number of times the testicle has rotated, which, when exceeded several times, can completely cut off blood flow to the testicle. This condition can occur to either or both of the testicles, due to unsecure attachment of the testicles inside the scrotum and their ability of free rotation inside it. Statistically, 10% of males are susceptible to this condition and have an inherited trait to it. Testicular torsion has no apparent trigger, and it can start after the following:


  • Physical activity
  • Scortum injury
  • Sexual activity or arousal
  • Sexual reflexes or arousal while asleep
  • Exposure to cold weather


A previous testicular torsion is one of the factors that may increase the risk of developing this condition. This is because unless the main cause of the condition is treated surgically, testicular torsion is likely to recur in either of the testicles.



Unless treated, it is likely that during several hours of blocked blood flow, the testicle may receive permanent damage and may have to be surgically removed. In some cases of testicle damage or loss, the patient may experience fertilely complications.


Even if a physician succeeded in untwisting a rotated testicle by manual detorsion, surgery is still necessary to prevent the recurrence of testicular torsion, which might not be possible if the testicular torsion has occurred before birth. General anesthesia is recommended during surgery for testicular torsion, which has a clear procedure and the patient doesn’t have to stay in the hospital. Surgery is carried out by the following steps:


  • An incision is made in the patient’s scrotum
  • In case the spermatic cord is twisted, the doctor untwists it
  • Then, the doctor stitches either or both of the testicles to the inside of the scrotum to prevent rotation from recurring.


This procedure lasts approximately one hour, and the patient should avoid rigorous activity for one or two weeks and may restart sexual activity within four or six weeks.


Testicular torsion in newborns and infants:

Surgery may be required to diagnose and rectify a twisted testicle, which might produce complications in fertility and production of hormones in the future. The physician has to make the call for the need of surgery after consulting with the parents.


It may be too late for an emergency surgery for a newborn child diagnosed with testicular torsion, and a non-emergency surgery might be carried out upon the physician’s recommendation. An emergency surgery might be recommended if testicular torsion is diagnosed after birth.


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