Torsion occurs when the cord that supplies blood to a testicle becomes twisted, creating an immediate medical emergency that requires prompt intervention to save it from death or permanent damage.
Healthcare providers can diagnose it through scrotal ultrasound and physical exam of the testicles, in addition to ordering urinalysis and/or blood tests as needed.
Symptoms
Testicular torsion is an emergency condition in which one or both testicles become twisted, cutting off its blood supply and leading to its eventual destruction. Without immediate medical treatment, affected testicles can die. Symptoms of Scrotal Palpation may include sudden and intense pain that begins without apparent cause, often following sports activity or other forms of physical exertion; this pain may then spread across various parts of the scrotum before turning dark blue in hue (scrotal palpation). In some instances, an affected testicle may feel heavy or enlarged and appear higher than usual in the scrotum. Pain typically worsens within hours and often begins at night so as to wake a person up; nausea and vomiting may occur as the tissue dies and the pain lessens over time – although this doesn’t bode well because blood flow to that testicle will likely slow down significantly as its blood supply dwindles away.
Doctors can diagnose testicular torsion with a physical examination and questioning, in addition to using ultrasound of the scrotum as an aid for monitoring blood flow to testicles; this testicle might need additional testing depending on its status.
Due to its urgency, surgery must be performed immediately in order to protect and save the testicle from further damage and save its viability. Urologists or nephrologists who specialize in conditions related to urinary tract and kidneys perform this surgery through making a small cut in the scrotum to expose both testicle and spermatic cord and untwist them before reconnecting the affected testicle back onto it for blood flow restoration; both testicle can then be fixed so as to avoid future twisting in future cases.
Surgery should usually be conducted in a hospital and will likely involve pain medication being given beforehand, with any incision bleeding for one or two days afterwards. Following surgery, both boys and men must refrain from participating in activities which could retwist their testicle, such as playing sports or performing pushups, while taking nonsteroidal anti-inflammatory medications, like Ibuprofen, to reduce any swelling caused by their surgery.
Diagnosis
Testicles rest within a pouch attached to the penis (also called the scrotum), where each testicle is connected by its respective spermatic cord which contains blood vessels which transport oxygen-rich blood directly to its respective testicle. Testicular torsion occurs when this cord becomes twisted and cuts off blood supply to its testicle causing swelling and pain in that testicle – it should be treated quickly to avoid infertility or loss of testicular function altogether.
Symptoms of Scrotal Trauma may include sudden, intense pain in the scrotum that does not seem position-related, persists even with movement, causes nausea and vomiting and often leads to testis enlargement with no cremasteric reflex present on either side of the affected individual.
Diagnostic criteria consist of history, physical examination and ultrasound imaging – two thirds of cases require ultrasound for verification. When inspecting the scrotum and examing its contents for symptoms such as painful testis comparison to non-painful one should include Doppler ultrasonography examination for normal color and shape and flow as well as twisting in spermatic cord (large venous waveform over testis may indicate torsion is severe) examination for twisting as well.
Urologists or pediatric surgeons should be immediately contacted in an emergency situation to untwist and restore blood flow to untwist the spermatic cord and restore circulation. This may involve either manual detorsion or minimally invasive surgical operations to perform this operation.
Treatment should be sought as soon as possible to restore proper blood flow to the testicle or it will eventually die. A doctor can perform emergency surgery to save and stitch in place the testicle so it won’t twist back around in future episodes.
If you or your child experience severe testicular pain and swelling, seek emergency room attention immediately. An ER doctor will question you and conduct a physical exam of both your scrotum and testicles.
Treatment
Testicular torsion is an urgent situation as its blood supply quickly evaporates and permanent damage may ensue within six hours if left untreated. Your healthcare provider must perform surgery in order to untwist your spermatic cord and restore blood flow; in any other event permanent damage could ensue within hours and require surgery to correct.
Testicular torsion occurs in young boys or men when they experience sudden, excruciating pain in their scrotum that worsens quickly during physical activity or sleep; often unbearable pain may keep you pinned down; nausea and vomiting are frequently experienced as the testicle begins to die off and gradually ease as time progresses.
Your doctor can diagnose this condition by asking about your symptoms and medical history, examining your scrotum, and ordering an ultrasound to identify whether or not your spermatic cord has become twisted and how tightly it has wrapped around one of your testicles.
Some individuals are at greater risk for testicular torsion than others. Your risk could increase if you’ve ever experienced testicular torsion before or if any members of your family also do. Also, congenital conditions called bell clapper deformity increase your chance of testicle twisting by making testicles more freely move within the scrotum – increasing its chance of becoming twisted.
If the affected testicle hasn’t died yet, your urologist might attempt to manually detorsion it – this procedure entails rotating your testicle so it becomes more horizontal before fixing it in place to prevent future torsion. They might also perform orchiopexy (stitching the bottoms of both testicles to the walls of your scrotum).
Testicular torsion that has been slowly unraveling can be more challenging to treat, so your urologist should conduct this procedure without further tests, within one hour of experiencing symptoms so the injured testicle has the best possible chance of surviving. In extreme cases, your urologist might need to remove the testicle altogether which may affect male fertility – though this usually isn’t a serious concern for most people.
Recovery
Testicular torsion can only be treated by surgery to untwist the spermatic cord and restore blood flow to the testicle, often saving it altogether. A surgeon may stitch another testicle in place so as not to twist again in future, with outpatient procedure being recommended so your child or teen doesn’t have to stay in hospital overnight for this process.
Men and those assigned male at birth (AMAB) rely on their spermatic cord to supply blood to their testicles. Testicles are long, thin tubes-like structures located in a pouch called the scrotum below the penis that produce hormones and make sperm. Torsion occurs when one or more of these testicles is cut off from blood supply due to twisting spermatic cords; chances of saving that testicle diminish within six hours without treatment being provided immediately.
To identify testicular torsion, a doctor must conduct a comprehensive examination of the scrotum, abdomen and groin area. They will look for signs of swelling, edema or redness as well as small holes or lumps within the scrotum that cause pain when moving from lying down to standing or sitting up, along with scans or ultrasound images to provide a more clear view of both testicles and their blood flow. Furthermore, blood and urinalysis tests might be done as well to detect whether antibodies within your body could interfere with testicle blood flow.
If a person experiences symptoms of testicular torsion, they should immediately visit an emergency room. A physician will conduct an extensive medical history review and examination; then perform an ultrasound to check blood flow to see if their testicle has become twisted; they might attempt manually untwisting to restore circulation if it is still possible; otherwise they will opt for emergency surgery as soon as possible.
At surgery, your child or teen will undergo a procedure in which a surgeon makes cuts in their scrotum to unwind spermatic cord and restore blood flow to both testicles. They may stitch one testicle back onto its place in the scrotum while simultaneously stitching both testicles together so as to prevent future twisting of testicles. Your child or teen will receive painkillers and general anesthesia during this procedure so they won’t experience pain during their procedure and afterwards be taken directly to recovery room after their operation has concluded.
