Testicular Torsion - Causes, Symptoms & Treatment
Medically Reviewed by Dr Sravya, MBBS, MS
Introduction
Testicular torsion is the most frequent cause of a male genitourinary emergency that is extremely painful.
The two testicles that men have are located inside the scrotum. Blood travels to the testicles along a cord known as the spermatic cord. This cord twists when the testes are torn. As a result, the testicular tissues may begin to die and blood flow may be hampered.
The condition known as testicular torsion occurs when a testicle twists inside the scrotum, cutting off the testicle’s blood supply. The testicle can perish from a lack of oxygen if there is insufficient blood supply, and in extreme circumstances, removal may be necessary. Therefore, it is important to address suspected testicular torsion as a medical emergency. Your testicle may need to be surgically removed if the blood supply doesn’t improve rapidly (within six hours).
The American Urological Association estimates that just 1 in 4,000 people under the age of 25 have this illness, which is rare. Male adolescents experience torsion the most frequently. 65 percent of those with the disease are between the ages of 12 and 18. Infants and elderly people, however, may also be impacted.
An extremely significant medical emergency is testicular torsion. Call your doctor or get straight to the emergency room (ER) if you experience sudden, severe discomfort in one of your testicles.
The longer you wait to get treatment for testicular torsion, the greater the chance that you will lose your testicle:

- If patients receive therapy within four to six hours, almost everyone maintains their testicles.
- If therapy is received within 12 hours, over half of patients maintain their testicles.
- If they receive therapy after 24 hours, just about 10% of people retain their testicles.
Testicular Torsion symptoms
Testicular torsion is characterized by sudden, excruciating pain in one of your testicles. It can happen whenever you’re awake, asleep, standing, sitting, or engaged in activity.
Other signs include-
- Painful scrotal swelling on one side.
- A testicular lump that can be seen.
- Your scrotum has a discoloration (red, purple, brown, or black).
- Vomiting and nauseous.
- Ache in the abdomen.
- Greater than typical urination.
- Fever.
Even if you have no other symptoms other than abrupt pain or discomfort in one or both testicles, you should still seek medical attention right soon. Yet another indication of a medical emergency.
Testicular Torsion causes
In those who are susceptible, testicular torsion can happen at any time, even when standing, sleeping, exercising, or sitting, and there is no known trigger. It can occasionally happen as a result of an accident or rapid growth during puberty.
The cause of testicular torsion is unknown. The testicle can rotate freely inside the scrotum in most males who have testicular torsion due to a hereditary characteristic. Both testicles are frequently affected by this genetic illness. However, not all men with
the characteristic will experience testicular torsion. Testicular torsion frequently happens many hours after strenuous activity, after a small
testicular injury, or while you’re resting. Another factor could be the testicle’s quick growth during adolescence or the cold weather.
Testicular torsion is more likely in situations where-
- Age: - Males under the age of 25 are most at risk for testicular torsion, which frequently affects male adolescents between the ages of 12 and 16 years.
- Testicular torsion in the past: - If the torsion happens once and goes away without treatment, it will probably reoccur again in either testicle unless the underlying issue can be fixed through surgery.
- Climate: - Because torsions frequently happen in cold weather, many medical professionals refer to them as "winter syndrome." For instance, when lying in a warm bed, a person's scrotum is frequently in a relaxed state. The scrotum is exposed to the chillier ambient air when the person gets out of bed. The rapid contraction brought on by the abrupt temperature shift can hold the testicle in that position, leading to testicular torsion, if the spermatic cord twists while the scrotum is free.
when lying in a warm bed, a person’s scrotum is frequently in a relaxed state. The scrotum is exposed to the chillier ambient air when the person gets out of bed. The rapid contraction brought on by the abrupt temperature shift can hold the testicle in that position, leading to testicular torsion, if the spermatic cord twists while the scrotum is free.
Torsion of the testicles in babies and young children
Testicular torsion can happen just before or right after birth. Normally, the testicle cannot be saved in this situation.
To detect and treat testicular torsion in the other testicle and avoid further reproductive issues, the child will need surgery after birth.
Testicular Torsion diagnose
- Based on the symptoms and physical characteristics of the scrotum, the diagnosis is frequently considered. An ultrasound scan is typically used to confirm the diagnosis, or, more frequently, emergency surgery. To rule out any additional causes for the symptoms, blood and urine tests may also be performed.
- The patient's cremasteric reflex may also be examined by a medical practitioner because it is a powerful tool for diagnosing torsion. The affected side of the inside of the thigh is lightly rubbed or pinched during this examination. Testicular torsion typically prevents the reflex from happening, despite the fact that this generally causes the testicle to contract.
- To determine if symptoms are brought on by testicular torsion or another problem, exploratory surgery may also be required. In order to avoid further issues, the surgeon may still attach the testicle to the scrotum wall if the procedure does not indicate torsion.
- An operation to save the testicle may be performed without further testing if discomfort lasts for several hours and a physical examination indicates testicular torsion.


Testicular Torsion treatments?
Treatment will be planned according to the cause of epididymitis.
- Torsion of the testicles necessitates surgery (orchiopexy). A surgeon will untwist your testicle during an orchiopexy, restoring blood flow to the area. They will then use stitches (sutures) to attach your testicle to an inner scrotal wall. This stops testicular torsion from happening once more. Under general anesthesia, testicular torsion surgery is typically performed.
- Usually, the surgeon will access your scrotum for surgery, but occasionally, they will need to make a little cut (incision) through your groin. Torsion typically affects both testicles in people who have a bell clapper malformation. the unaffected testicle will likewise be attached to the inner scrotal wall by the surgeon in this situation.
- By pressing on the scrotum (manual detorsion), the doctor may occasionally be able to untwist a testicle. However, surgery is still required to stop torsion from happening again.
Torsion of the testicles in babies and young children
- Although it's uncommon, testicular torsion can happen in newborns and infants. The testicle of the child may be firm, enlarged, or darker in color. Surgery might be required to confirm torsion of testicles. Since ultrasound might not be able to detect diminished blood flow to the infant's scrotum.
- Treatment for torsion in testicles in infants is controversial. There are hazards involved with general anesthesia and it may be too late for emergency surgery to help if a child is born with testicular torsion signs and symptoms. Emergency surgery, however, can occasionally save the testicle whole or in part while also preventing torsion in the other testicle. It may be possible to avoid future issues with male hormone production and fertility by treating testicular torsion in babies.
Complications of Testicular Torsion
If left untreated, testicular torsion may result in:
- Your testicle will be permanently damaged if: Your testicles can only go without blood for roughly six hours. A surgeon must remove your testicle from your scrotum if it dies.
- Infertility in men: According to studies, 1 in 3 people who get testicular torsion have a decreased sperm count. Your capacity to have a biological kid may be impacted by a low sperm count.
Frequently Asked Questions
Yes, males can acquire fungal infections, particularly in the genital area. Although it is less frequent in men than in women, men must recognize the signs and seek proper treatment.
No, fungal infections are not classified as sexually transmitted infections. However, sexual activity can sometimes upset the natural balance, increasing the risk of infection.
While vaginal yeast infections are more frequent in women, they can occur in men as well, mainly through sexual transfer.
For minor yeast infections, over-the-counter antifungal treatments can be beneficial. However, if symptoms persist or worsen, it is essential to seek medical attention.
Stress can impair the immune system, making it more difficult to battle illnesses such as yeast infections.