Testicular torsion occurs when your spermatic cord twists and cuts off blood flow to one of your testicles, causing sudden pain and necessitating medical attention immediately.
Your testicle could die within six hours if it does not receive enough blood supply; to save it you should seek treatment immediately.
Ultrasound
Most men tend to take for granted how their testicles connect to their scrotum until they experience testicular torsion, a medical emergency in which blood supply to each testicle becomes cut off due to twisting of its spermatic cord (which provides blood) inside their scrotum, leading to testicle death within six hours unless blood can be restored through doctors.
Doctors rely on ultrasound scans to diagnose testicular torsion accurately. This test allows doctors to see all aspects of the scrotal structure, including each testicle and epididymis; additionally it shows blood flow through each testicle – low flow indicates torsion while normal flow indicates it is untorsed.
Urologists must perform surgery and restore blood flow to both testicles for successful restoration, providing immediate pain relief to most patients while potentially saving both testicles.
Testicular torsion is more prevalent among boys and men between 12-18, particularly after physical exertion or during sleep. It can occur after strenuous activity or by trauma to the scrotum; but can also result from genetic conditions like bell clapper deformity where testicles don’t connect directly to scrotum and are therefore more prone to turning or twisting.
Testicular torsion symptoms may resemble other health conditions, so it’s vital that if you notice these signs immediately. Doctors can save most testicles by restoring blood flow back into them within 6 hours after symptoms first emerge – they may do this manually or with detorsion devices if possible.
Ultrasound imaging can be an invaluable diagnostic tool in resource-poor settings where other imaging modalities may not be accessible.1 Ultrasound provides fast, portable images of high quality that compare favorably with other diagnostic modalities when diagnosing testicular torsion.2
An important strategy for raising awareness of testicular torsion among young males and their parents is raising awareness about this condition so it’s easier for both of them to recognize it quickly and seek immediate treatment. Doctors can assist by spreading this information during office visits, school health classes and on social media; additionally they may encourage adolescent boys to practice proper scrotal positioning, teaching self-checks for testicular torsion as well as encouraging proper scrotal positioning practices and helping with self-checks themselves.
Urinalysis
Urine tests can be an invaluable way to screen for numerous health conditions, including diabetes and kidney disease, as well as infections like gonorrhea and chlamydia. A urinalysis can be performed at home or in a laboratory. Before the test, be sure to consume plenty of fluids so your urine sample is full and concentrated; certain medications may alter its results – your healthcare provider will give instructions about this as part of their test protocol.
Urinalysis involves visual inspection and analysis of urine. This test can detect abnormalities such as red blood cells or an excessive number of bacteria in your urine, and also helps identify infections such as urinary tract infection or bladder cancer.
Your healthcare provider will use a small tube called a catheter to collect urine sample, making the procedure safe and painless. Urine samples will typically be sent to be tested in a laboratory; depending on why this urinalysis is being conducted, your healthcare provider might want to collect it first thing in the morning when urine concentration levels are highest.
Testicular torsion often manifests itself in severe, sudden pain that radiates quickly across one testicle and quickly spreads throughout the scrotum and spermatic cord. It may begin during sports activity or physical exertion or be worse at night while sleeping – though its intensity typically subsides as the torsion progresses.
If you suspect testicular torsion, it’s crucial that you seek medical assistance immediately. There is only a 4-6 hour window in which to save the testis before irreparable damage occurs. If diagnosis remains uncertain, consulting with a urologist for ultrasound examination of both testis and scrotum may provide clarity; in severe cases surgical exploration must occur immediately; otherwise evaluation for possible causes (incarcerated inguinal hernias or torsion of another testicular appendage such as Torsion of Torsion of Morgagni).
Manual Detorsion
Manual detorsion is a surgical maneuver intended to untwist and restore blood flow to the testis, usually performed during emergency department visit or before further intervention is needed. Sedation or regional anesthesia may be utilized in order to ease discomfort and minimize further interventions required in these instances.
Ideal, testicular torsion should be diagnosed prior to or during hospital emergency evaluation and immediately resolved with surgery for permanent resolution, thus providing for testicular salvage by preventing torsion on the contralateral side. Unfortunately, however, this may not always be possible due to time restrictions and patient anxiety; acute spermatic cord torsion requires swift intervention in order to preserve testicular viability.
Acute Spermatic Cord Torsion occurs when one testis rotates and twists its spermatic cord – an attached structure between testis and sperm – in such a way as to compromise its blood supply, potentially endangering life if left unremedied. Symptoms may include sudden onset of scrotal pain, swelling and nausea or vomiting with inability to sit up straight due to severe pain; diagnosis typically made on physical examination and confirmed using Doppler ultrasound technology.
Manipulative reduction of testicular torsion was first documented as early as 1893 and has become a standard part of treatment ever since. For optimal success rates it should be attempted upon presentation to an emergency department; with increased time passed between symptoms arising and surgical intervention increasing success rates can diminish rapidly; while any presence of scrotal edema, induration or adhesions from previous epididymitis can complicate but should not rule out this approach to treatment.
Manual detorsion can be defined as successful when it results in relief of pain and restoration of vascular flow on color Doppler ultrasound. A successful manual detorsion procedure entails positioning the patient supine with their affected testis held between thumb and forefinger of their respective hands (ie physician’s right thumb and forefinger for left testis). Once in position, their affected testis should be rotated caudal-to-cranial (lifting slightly upward to release cremasteric reflex) 180 degrees medial-to-lateral (like opening a book). This procedure should be repeated as necessary until pain relief occurs.
Surgical Detorsion
Your body supplies blood to each testicle via two spermatic cords (also called testicular cords). Normally, these cords are attached to tissue that holds your testicles in your scrotum, but your testicles can rotate and twist out of place, cutting off its blood supply within approximately six hours if it becomes twisted in this condition. Without blood flow a testicle could die; symptoms include sudden severe pain in one testicle as well as swelling in your scrotum.
Your healthcare provider will conduct a physical exam to detect whether or not you have a twisted testicle, while also looking for signs of blood flow to the affected testicle. They may order an ultrasound imaging procedure which uses sound waves to create pictures of both testicles and scrotum; ultrasound can show whether or not your spermatic cord is functioning effectively.
If doctors suspect testicular torsion, they will attempt to untwist your testicle as quickly as possible and evaluate its blood supply and health, along with any possible damage to its spermatic cord, in order to save it if at all possible. Otherwise, surgery called orchiectomy may be required; most boys who undergo testicular torsion eventually can still father children despite losing one or both testicles during this process.
Your healthcare provider will decide how long you need to remain hospitalized based on the severity and duration of your symptoms. Your doctor will suggest rest and using condoms until it is safe to resume sexual activity. Boys who fail to get immediate treatment may have issues with fertility in the future. Young men often have lower sperm counts, limiting their ability to have biological children. Furthermore, boys who experience testicular torsion will likely require an artificial orchicle in the future; it is therefore wise to discuss your fertility plans with a healthcare provider who specializes in men’s health such as a urologist or another provider with experience treating male health.
