Testicular Torsion

Causes

The reason why testicular torsion happens is not clear. It may be due to recent trauma or activity.

Risk Factors

Testicular torsion is more common in newborns and in boys who are 12 to 18 years of age.

Other things that may raise the risk are:

• Other people in the family who have had this problem
• Having this problem with the opposite testicle

Symptoms

A key sign is sudden, intense pain in the testicle or scrotum. The pain is often felt only on one side. Other problems may be:

• Nausea
• Vomiting
• Swelling, redness, and warmth of the scrotum
• A change in the position of the testicle

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. This is often enough to make the diagnosis.

Pictures may be taken right away to confirm it. This can be done with Doppler ultrasound.

Emergency treatment may need to be started right away before testing. The diagnosis will be confirmed during surgery.

Treatment

This problem needs to be treated within 4 to 8 hours to prevent tissue death. The testicle may be untwisted by hand, but surgery will still be needed.

Surgery will restore blood flow, repair or remove any damaged tissue, and prevent further twisting. It may be done with either:

• Detorsion with orchiopexy to untwist the spermatic cord and secure each testicle to the wall of the scrotum to stop future twisting
• Orchiectomy with orchiopexy to remove a badly damaged testicle and secure the other testicle to the wall of the scrotum

Prevention

There are no current guidelines to prevent testicular torsion.