Testicular Torsion
Author : Professor Mahmoud Fawzy Ghaly
• Updated at: Jun 09, 2024 •
Testicular torsion is a medical condition that requires immediate medical intervention.
Testicular torsion occurs as a result of the testicle moving in a wrong position inside the scrotum. This can cause a degree of twisting (anywhere from 180-720 degrees) of the spermatic cord impairing testicular blood flow. This blood flow impairment of testicular tissue causes sudden severe pain and swelling. The patient should seek medical attention at the Emergency Room of the nearest hospital to receive immediate surgical intervention to save the testicle before the tissues are irreversibly damaged.
Testicular torsion
The testicles are the most important organ in the male reproductive system. They are responsible for producing sperm. The spermatic cord provides the testicular blood supply to carry out their functions. If the spermatic cord is twisted, cells and tissues in the testicle may irreplaceably be damaged causing necrosis (death of tissue) and loss of one or both testes. To prevent this action should be taken within the first six hours of the torsion occurring.
Testicular Torsion Symptoms
Testicular torsion occurs in men of all ages but is more common in teenagers between the ages of 12 and 18 years. The symptoms of testicular torsion are visible and clear but may differ in newborns if an infant wakes up in the middle of the night inconsolable with a swollen, red scrotum or vomiting immediately take him to the ER for referral to a pediatric urology surgeon.
Testicular Torsion symptoms include the following:
- Severe and sudden pain in the scrotum (the skin pouch containing the testicles)
- Swelling in the scrotum or a testicle that is raised from its normal place or rests at a different angle.
- Fever
- Feeling tired, nauseous, and wanting to vomit.
- Urinating a lot and feeling pain in the pelvic area
Testicular torsion causes
The testicular torsion causes are not yet clear they could be due to a wrong movement or vigorous activity, trauma or in sleep but the main cause is believed to be genetic. Due to pregenetic disposition some men inherit testicles that move more freely in the scrotum than others and torsion often occurs bilaterally (on both sides). At any given time if onset of acute pain and swelling occurs in scrotum consult a doctor immediately to save testicular function, even if the torsion resolves on its own, surgery is needed to prevent it from happening again.
Testicular torsion surgery
Surgical intervention to resolve testicular torsion (testes torsion) is a necessity, even if the doctor was able to resolve the torsion manually by pressing the scrotum. The testicular torsion surgery takes about 40 minutes to an hour, and the patient will undergo general anesthesia. The surgeon makes a small incision in the scrotum, untwists the spermatic cord and fixates (orchiopexy) the testicles in place with stitches to prevent them from twisting again.
The patient will be monitored to ensure the success of the operation, and the doctor might conduct some tests and analyses to ensure that everything is fine. The patient must follow the following instructions:
- Comply to prescribed medication usually painkillers and antibiotics
- Avoid any physical exertion or lifting heavy weights, some walking is advised though to improve blood circulation.
- Avoid applying pressure during defecation.
- Avoid sexual intercourse during recovery.
- Follow a healthy diet, decrease sugar intake.
- Quitting smoking drink alcohol in moderation
The recovery period is usually from 2-4 weeks after the procedure.
Testicular torsion surgery side effects
The most common testicular torsion surgery side effect is erectile dysfunction. The patient regains his ability to have an erection from two to four weeks after the procedure. The doctor will follow up with the patient until his ability to have an erection improves, it may be necessary to prescribe some Erectile Dysfunction (ED) medication as treatment if this situation prolongs after 4 weeks.
