Testicular Torsion Definition, Reason, Symptoms, Treatment & Prevention
Definition
Testicular torsion is a condition where there is a rotation of the testicle that results in the twisting of the spermatic cord that sends blood to the scrotum. The decrease in blood flow can cause sudden and often severe pain accompanied by swelling.
This condition most often occurs between the ages of 12 and 16 years. However, it does not rule out the possibility of occurring at any age, including before birth.
Testicular torsion generally requires immediate surgery. If you get timely treatment, the testicles can generally be saved. However, if blood flow is stopped for a long time, the testicles can be permanently damaged requiring removal.
Testicular Torsion Symptoms
Signs and symptoms of testicular torsion that are commonly complained of can include the following:
- Sudden and severe pain in the scrotum, the skin sac under the penis that contains the testicles
- Swelling of the scrotum
- Abdominal pain
- Nausea and vomiting
- Position of the testicles that are higher than normal, or at an unusual angle
- Pain when urinating
- Fever
Boys with testicular torsion often wake up with intense pain in the scrotum in the middle of the night or early in the morning.
Testicular Torsion Reason
Testicular torsion occurs when there is rotation of the testicles on the spermatic cord, which drains blood from the abdomen to the testicles. When the testicle undergoes rotation several times, the blood flow can stop completely, which results in faster damage.
It is not known exactly what causes testicular torsion. Most males who experience testicular torsion have a condition in which the testicles rotate freely within the scrotum.
Testicular torsion often occurs hours after strenuous activity, minor injury to the testicles, or while sleeping. Cooler temperatures and more rapid testicular development at puberty may also play a role.
Some of the risk factors associated with testicular torsion are:
- Age. Testicular torsion is most often observed in boys aged 12 to 16 years.
- Prior history of testicular torsion. Individuals who have experienced testicular pain before, which goes away on its own, have a higher chance of experiencing testicular torsion. The more often pain is experienced, the higher the risk of testicular damage.
- Family history of testicular torsion. People who have family members with a previous history of testicular torsion have a higher chance of experiencing testicular torsion.
Diagnosis
The diagnosis of testicular torsion is generally determined based on the results of a detailed medical interview, direct physical examination, and certain supporting examinations that are needed.
During a medical interview, the doctor will ask questions regarding the signs and symptoms you are experiencing. In addition, they will also carry out a physical examination of the scrotum, testicles, abdomen and groin.
Several investigations that can be carried out to confirm the diagnosis or identify other causes that cause signs and symptoms are:
- Urine examination. This examination can be done to see the presence of infection in the urinary tract.
- Ultrasonography (USG) of the scrotum. An ultrasound examination is done to check blood flow. Decreased blood flow to the testicles can be a sign of testicular torsion.
If pain has been experienced for several hours and the results of the physical examination indicate that the signs and symptoms are most likely due to testicular torsion, surgery can be performed without prior investigation. This is done to prevent testicular damage that occurs due to delayed surgery.
Testicular Torsion Treatment
In most cases, surgery is needed to correct the rotation that occurs with testicular torsion. In some cases, the doctor can reposition the testicles by pushing on the scrotum, a procedure called manual detortion.
Surgery for testicular torsion involves making a small incision in the scrotum, rewinding the spermatic cord, and if needed, attaching one or both testicles to the inside of the scrotum. The sooner the testicles are repositioned, the more likely they are to be saved.
Prevention
Until now there is no preventive method that can be suggested to avoid testicular torsion. This is related to the cause of testicular rotation in testicular torsion which is not known for certain.
However, experts are currently investigating several operative methods that are thought to prevent testicular torsion, which can be performed in people who have a high probability of experiencing testicular rotation in the scrotum. However, the risks and benefits of these prevention methods are still being considered.