Surgery is frequently needed to prevent the problem from happening again. Testicular torsion occurs when the testicle rotates on the spermatic cord, which brings blood to the testicle from the abdomen. If the testicle rotates several times, blood flow to it can be entirely blocked, causing damage more quickly. It's not clear why testicular torsion occurs. Most males who get testicular torsion have an inherited trait that allows the testicle to rotate freely inside the scrotum.
This inherited condition often affects both testicles. But not every male with the trait will have testicular torsion. Testicular torsion often occurs several hours after vigorous activity, after a minor injury to the testicles or while sleeping. Cold temperature or rapid growth of the testicle during puberty also might play a role. Having testicles that can rotate in the scrotum is a trait inherited by some males. If you have this trait, the only way to prevent testicular torsion is surgery to attach both testicles to the inside of the scrotum.
Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Urgent medical attention is needed to save the testicle when torsion is diagnosed. Surgery must untwist the spermatic cord and restore blood flow to the testicle.
A doctor uses physical examination and ultrasound scans to make the diagnosis. Sometimes, a doctor can only make a conclusive diagnosis at the time of surgical exploration. The survival rate of the affected testicle is poor unless surgery is performed within four to six hours of the injury.
Unnecessary investigations should not take place if torsion is suspected, as delays to surgery can affect the viability of the testis. If the blood supply has been disrupted for too long, the testis may not be viable or salvageable, and may need to be removed.
In many cases, the surgeon will also secure the spermatic cord on the unaffected side, to prevent future torsion of the other testicle. If the torted twisted testicle has to be removed, then a surgeon can put a prosthesis or silicone testis into the scrotum for cosmetic reasons usually at a later date.
The appendix testicle is a small tissue structure located at the upper third of the testicle. Torsion of the appendix testicle means that the structure has twisted and cut off its blood supply. This condition is easily confused with testicular torsion because the symptoms are so similar. However, the onset of pain is slower and the condition often presents with a noticeable blue dot on the surface of the scrotum.
This blue dot is the darkened appendix testicle. Surgery is needed to correct the problem, but the testicle is not at risk. Testicular cancer is an abnormal growth or tumour that appears as a hard and usually painless lump in either testicle.
In most cases, testicular cancer can be cured if the person seeks medical treatment early. Surgical removal of the affected testicle orchidectomy is usually the first treatment for all testicular cancer. Testicles are easily injured because they are not protected by muscle or bone. The main types of possible injuries include:. A doctor can assess injuries to the testicles by physical examination and ultrasound.
If the testicles seem normal, the doctor may prescribe pain-relieving medication. Even without an ultrasound, a surgeon may choose to explore the testicle, particularly in cases of possible testicular torsion. Surgery is usually performed under a general anaesthetic. Significant injury to the testicles may require surgical exploration and repair or, potentially, removal of the affected testis. After 6 hours, lasting damage may occur, and after 12 hours, there is a 75 percent chance of losing the testicle.
After surgery, the patient will need to avoid strenuous activity and sexual activity for several weeks. Having testicles that can rotate or move back and forth freely in the scrotum is an inherited trait. Some males have this attribute and others do not. The only way to prevent testicular torsion for a man with this trait is through surgery to attach both testicles to the inside of the scrotum so that they cannot rotate freely.
The majority of cases, if treated within 6 hours, do not require the removal of the testicle orchiectomy. However, if treatment is delayed for 48 hours, the majority of patients do need to have the affected testicle removed. Rarely, torsion happens on both sides, but only in around 2 out of every If a testicle is removed, it does not mean that a man cannot have children.
The remaining testicle will still produce sufficient sperm to conceive. However, low sperm count has been observed in men who have undergone a torsion.
Sometimes, the remaining testicle will grow larger to compensate. The man should consider wearing protective clothing when doing sports and other activities, to preserve the second testicle. Some adults may want to undergo circumcision for religious, cosmetic, medical, or cultural reasons. Learn about the procedure, including the risks and…. What is posthitis? Read on to discover what it is, how it differs from other forms of inflammation in the penile area, causes, and how to treat it.
It may happen during exercise, sitting, standing or even sleeping. Testicular torsion is often found with a physical exam by a doctor. X-ray tests may also be used. Ultrasound and other techniques can check blood flow to the testes. If a urine test shows a urinary tract infection, your health care provider will do more tests. He or she will want to know if the pain is from an infection of the testicle or epididymis. The epididymis is a coiled tube on the back of the testes.
The spermatic cord needs to be untwisted de-torsion to restore the blood supply. Lasting damage starts after 6 hours of torsion. 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.
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