Testicular Torsion

Testicular torsion is a medical emergency in which a boy’s testicle twists and is deprived of its blood supply. Emergency surgery will usually be needed to save the testicle. Testicular torsion can happen in boys of any age and most who experience testicular torsion are affected on only one side.

What Causes Testicular Torsion?

In normal anatomy, two testicles rest within the scrotum, the sack of skin that hangs below the penis. A small ligament and the spermatic cord, a series of blood vessels, connect each testicle to the rest of the body. If the spermatic cord rotates or twists within the scrotum, the testicle will become deprived of its blood supply. There is usually no explanation for what triggers torsion.

What Are the Symptoms of Testicular Torsion?

Sudden scrotum pain is the main symptom of testicular torsion and should always be taken seriously. 

In addition to pain in his scrotum, your son may:

  • Experience abdominal or groin pain
  • Feel nauseated or lightheaded
  • Vomit
  • Develop swelling on the affected side of his scrotum
  • Notice that one testicle appears higher than the other, which means the spermatic cord has shortened as it twisted.

With testicular torsion, your son may be able to identify when the pain began, and this information is helpful during evaluation.

How Is Testicular Torsion Diagnosed?

Urgent attention is the best course of action for testicular torsion. When the testicle’s blood supply can be restored promptly, the testicle will typically recover. During the evaluation, we may order imaging, such as Doppler ultrasound, before surgery. Blood and urine tests may also be used to check for infection. We will perform a physical exam and check for torsion by examining reflexes of the testis. During the exam, we will also attempt to untwist the testicle using manual methods. 

Even when we successfully untwist a testicle, prompt surgery is required to help the testicle return to health. We will also check for a related condition, appendix testis torsion. Appendix testis torsion can be very painful, but it will not threaten your son’s health. If appendix testis torsion is diagnosed, we may recommend surgery to remove the twisted tissue and relieve your child’s pain.

How Is Testicular Torsion Treated?

Upon diagnosis of testicular torsion, we will need to operate immediately to have the best chance of saving the testicle. At Lurie Children’s, a pediatric urologist is always on call to treat emergencies like testicular torsion. 

After general anesthesia, an experienced surgeon from Lurie Children's Division of Urology will make a small incision in the scrotum and untwist the affected testicle. Stitches are used to anchor the testicle internally, to prevent future problems. In some instances, the testicle may be beyond repair. If that is the case, we will remove the tissue during the surgery.

If you believe your son is experiencing testicular torsion, seek emergency medical attention immediately.

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