Testicular torsion

What is testicular torsion?

Each testicle hangs down from a cord called the spermatic cord. Within this cord are the blood vessels that supply the testicle and a tube that carries sperm away from the testicle. If the testicle twists on the cord, the blood supply to the testicle is cut off. This usually happens in the teenage years, but can affect men of any age (although it’s uncommon after the age of 25).

Symptoms

• Sudden and excruciating pain, much worse than being kicked in the testicles. It can be so bad a man may vomit or faint.
• Sometimes the pain is felt deep within the abdomen because the nerves to the testicle originate here.

Causes and risk factors

The twisting may follow strenuous activity. Often, however, it happens spontaneously for no apparent reason and can even happen during sleep. It may be that in some men the spermatic cord is looser and allows the testicle to twist around more easily.

Treatment and recovery

Urgent medical treatment is necessary to untwist the cord and save the testicle (with its blood supply cut off, the cells of the testicle will soon die). This involves a simple operation during which both testes are stitched to tissues in the scrotum to fix them in place so neither can twist and cause problems in the future.

Prompt treatment within six hours of the pain starting usually prevents permanent damage. If the testicle is damaged, however, it will be removed.

Sometimes the cord spontaneously untwists before treatment is provided. However, because there's a high risk of it twisting again, arrangements will usually be made to perform the operation to fix the testes at an appropriate time.