When a testicle testis twists around in the scrotum, the condition is called testicular torsion. An emergency operation is usually needed to treat this condition.
In some young men the tissues that surround the testicle testis in the scrotum are lax. Therefore, the testes can move around in the scrotum more than usual. This can be called a 'bell-clapper' deformity. If a testis twists around, the spermatic cord has to twist around too as it is fixed higher up. If this happens, the blood flow to the testis is blocked in the twisted spermatic cord. This is found to happen in around 1 in 4, young men.
Torsion of the testis most commonly occurs in teenage boys aged years. Newborn babies and younger children sometimes develop this problem.
It is uncommon over the age of 25 but does occur sometimes in older adults and can occur at any age. A testis with its blood supply cut off is likely to become damaged and die unless the blood flow is quickly restored. The typical symptom of torsion of the testicle testis is severe pain that develops quickly - within a few hours, often much more quickly. The pain might be in the lower abdomen tummy. This is because the testis and the tummy share a nerve supply. Any boy or young man with abdominal pain should have their testes checked.
Testicular torsion pain often starts during sport or physical exertion. Alternatively symptoms start in the night and the pain wakes you from sleep. Nausea and vomiting often also occur. A doctor will examine your scrotum, testicles, abdomen, and groin and might test your reflexes by rubbing or pinching the inside of your thigh.
This normally causes the testicle to contract, which probably won't happen if you have a testicular torsion. Sometimes, doctors will need to do surgery to be sure a problem is testicular torsion. A doctor may also perform immediate surgery without any other testing in order to save the testicle. This is more likely if the torsion has been going on for a while or if the doctor suspects a guy has a torsion after examining him.
Testicular torsion almost always requires surgery to correct. In rare cases, the doctor might be able to untwist the spermatic cord by pushing on the scrotum, but most guys will still need surgery to attach both testicles to the scrotum to prevent torsion from happening in the future.
Usually, surgery for a testicular torsion doesn't require a stay in the hospital. If you have a torsion, you'll be taken into an operating room at the hospital or doctor's office. You'll most likely be given a painkiller and general anesthesia , meaning you'll be unconscious for the surgery.
A surgeon or urologist will make a small cut in the scrotum, untwist the spermatic cord, and stitch the testicles to the inside of the scrotum to prevent future torsions. When that's finished, the doctor will stitch up the scrotum, and the patient will be taken to a room to recover for an hour or two. The surgery to attach the testicles to the scrotum takes about 45 minutes.
There may be some pain, but it shouldn't be too bad. It's much better than the torsion. Sometimes, if the torsion goes on too long, doctors won't be able to save the affected testicle. Doctors will need to remove it through a type of surgery called an orchiectomy.
Guys need to skip strenuous activities like sports and sex or sexual stimulation like masturbation for a few weeks after testicular torsion surgery. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version.
This content does not have an Arabic version. Overview Testicular torsion Open pop-up dialog box Close. Testicular torsion During testicular torsion a testicle rotates, twisting the spermatic cord that brings blood to the scrotum, the loose bag of skin under the penis that contains the testicles. Request an Appointment at Mayo Clinic.
Share on: Facebook Twitter. Show references Testicular torsion. Merck Manual Professional Version. Accessed March 31, Walls RM, et al. Selected urologic disorder. One study found that nearly 3 in 4 patients need the testicle removed "orchidectomy" if surgery is delayed past 12 hours.
Ideally you can see a urologist for treatment. All patients with torsion will need surgery. It is possible to untwist the chord in the emergency room, but surgery is still needed. At surgery, the urologist will untwist the testicle and sew stitches to prevent future torsion. Most often, this is done through the scrotum.
Sometimes it is done through the groin. If the testicle cannot be saved, the urologist will remove the testicle and sew stitches around the other testicle to prevent future torsion. This can only be determined at the time of surgery. The testes of newborns with torsion can rarely be saved. The testes are almost always infarcted dead. Emergency surgery is not the same with infants. With infants, there have been cases of the second side twisting shortly after birth.
This would leave the baby with no testes. With better anesthesia and post-op care, many pediatric urologists will operate within the first few hours or days of life. The infarcted testicle would be removed, and stitches would be used to prevent torsion in the second testis.
Whether the testicle is removed or not, surgery in the scrotum will take time to heal. You may need to take pain medicine for a few days. Within a few days to a week, you should be able to return to work or school. It's helpful to avoid strenuous activity or exercise for several weeks. You shouldn't notice the stitches around the testicles, and they shouldn't bother you. The stitches are there to keep torsion from happening again.
Torsion of the other testicle can't be prevented by changes in activity or by taking medicine. Only sewing stitches around the testicle will prevent future torsion.
If you feel pain or swelling, seek medical attention right away. If the twisted testicle is left in place, it still might shrink a bit, since lasting damage may happen. Sometimes, if one testicle is removed, the other may grow larger than normal. This is known as "compensatory hypertrophy. Only one working testicle is needed for normal fertility and male features.
A single testicle can make normal amounts of sperm and testosterone.
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