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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 16, but it can occur at any age, even before birth.

Testicular torsion usually requires emergency surgery. If treated within a few hours, the testicle can usually be saved. But waiting longer can cause permanent damage and may affect the ability to father children. When blood flow has been cut off for too long, a testicle may become so badly damaged it has to be removed.

Symptoms Causes Risk factors Complications Prevention

Signs and symptoms of testicular torsion include:

  • Sudden or 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

When to see a doctor

Seek emergency care for sudden or severe testicle pain. Prompt treatment can prevent severe damage or loss of your testicle if the cause of the pain is testicular torsion.

You also need to seek prompt medical help if you've had sudden testicle pain that goes away without treatment. This can occur when a testicle twists and then untwists on its own (intermittent torsion and detorsion). Even though the testicle untwisted on its own, you still need to see a doctor because surgery is frequently needed to prevent the problem from happening again.

Testicular torsion occurs when the testicle rotates on the spermatic cord, which brings blood to the testicle from the abdomen. If the testicle rotates several times, blood flow to it can be entirely blocked, causing damage more quickly.

Most males who get testicular torsion have an inherited trait that allows the testicle to rotate freely inside the scrotum. This inherited condition often affects both testicles. But not every male with the trait will have testicular torsion.

What causes testicular torsion is unknown. Signs and symptoms of testicular torsion may follow:

  • Physical activity
  • An injury to the scrotum
  • Cold temperatures
  • Rapid growth of the testis during puberty
  • Sleep
  • Age. Testicular torsion is most common between ages 12 and 16.
  • Previous testicular torsion. If you've had testicular pain that went away without treatment (intermittent torsion and detorsion), it's likely to occur again. The more frequent the bouts of pain, the likelier the testicle is to be permanently damaged.
  • Family history of testicular torsion. The condition may run in families.

Testicular torsion can cause the following complications:

  • Damage to or death of the testicle. When testicular torsion is not treated for several hours, blocked blood flow can cause permanent damage or death of the testicle. If the testicle is badly damaged, it has to be surgically removed.
  • Inability to father children. In some cases, damage or loss of a testicle affects a man's ability to father children.

Having testicles that can rotate in the scrotum is a trait inherited by some males. If you have this trait, the only way to prevent testicular torsion is surgery to attach both testicles to the inside of the scrotum.

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