Testicular torsion

Reviewed by Mr John Macfarlane, consultant urological surgeon

What is testicular torsion?

Testicular torsion usually only appears in young boys and is most common in their teenage years but is also sometimes seen in men up to the age of 30 or on rare occasions older men.

The testicles are nourished by the blood vessels, which together with the nerves and the sperm channels pass through the spermatic cord from the abdominal cavity to the scrotum.

The testicles hang loose in the scrotum and in rare cases they are twisted, so that the channel with the blood vessels is tightened. This blocks the bloodflow to the testicles.

What does testicular torsion feel like?

Boys with testicular torsion get sudden pain and swelling of the scrotum. The testicles become sore. The condition may be so painful that it causes nausea and vomiting. It will mimic infection (acute epididymo-orchitis) but it is very important to seek urgent treatment.

How is testicular torsion treated?

Immediate surgery - ideally within six hours of the pain starting - is the recommended treatment.

The torsion that has tightened the blood vessels is removed and the failed blood circulation to the testicles is brought back to normal.

In order to prevent torsion happening again, the testicles are sewn to the innerside of the scrotum (testicular fixation). It is usual to fix the opposite testicle at the same time.

In cases where the circulation of blood has been blocked for a long time it may be necessary to remove the testicles. The operation is called orchidectomy.

If only one testicle is removed the ability to reproduce will not be affected.

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