Testicular torsion is a medical emergency and requires immediate treatment in an ED. This article details symptoms, diagnosis and management in an emergency department (ED).
The doctor will conduct an exam that includes examination of your scrotum, testicles, abdomen, and groin. They may test for cremasteric reflex by lightly pinching or rubbing inside of the affected leg thigh on that side – this usually causes testicles to contract but won’t happen with torsion.
Symptoms
Testicular torsion symptoms usually start off with sudden, severe pain that quickly spreads across both testicles. Swelling may occur and nausea and vomiting may follow shortly afterwards; pain from testicular torsion can spread rapidly across a person, especially if it has developed within the past few hours; sudden abdominal pain should be taken seriously as an emergency medical situation requires prompt attention from medical providers.
Torsion pains can be so intense, they can cause shock or even death if left untreated promptly. Furthermore, should a testicle lose its blood supply it will die and must be surgically removed to keep you alive; your risk increases when symptoms last more than eight hours.
Doctors perform physical exams of the abdomen, groin and scrotum to diagnose symptoms in their patients’ abdomens, groins and scrotums in order to identify what’s causing their discomfort. He’ll ask about health history as well as any symptoms they’ve been experiencing; in addition, they use cremasteric reflex to see if an affected testicle contracts, by lightly pinching inside thigh on affected side – healthy testicles will contract when lightly rubbed against or pinched inside thigh on affected side – reliable healthcare professionals use this testicular torsion diagnosis method as this test doesn’t occur when testing individuals whose testicle torsion symptoms have set in.
If a doctor suspects a child has testicular torsion, he’ll take him straight to an emergency room. Nurses should know the signs and symptoms so they can recognize it early and notify a urologist right away. Nurses can also prepare the patient for surgery by installing an IV line, treating any associated pain relief measures and giving antianxiety medications as soon as they’ve recognized what’s happening.
Doctors use the testicular detorsion maneuver to restore blood flow to affected testicles and avoid permanent damage. To use this technique, patients must lie supine; healthcare professionals then grasp gently their testicle while rotating it away from its midline body location like opening a book to untwist it and return it to its regular position after each full rotation of this procedure is completed. Most torsions will only require one full turn before returning back to its natural place after treatment is complete.
Diagnosis
Testicular torsion can affect men of any age, though it’s most often seen among boys and young men as they reach puberty. This condition occurs when the tissue that supports two testicles becomes weak from exercise, sleeping or an injury to the scrotum; some men are born without this tissue so their testicles move freely in their scrotum and twist unexpectedly.
Testicular torsion symptoms typically include sudden, severe pain in one testicle and scrotal swelling, with or without lump formation or one testicle being higher than another. If these signs arise, contact your physician immediately – they’ll examine your scrotum, testicles and abdomen before likely performing tests like pinching the inside of your thigh to stimulate contraction of your testicles – although this won’t always work if your testicle has become torsed.
Doppler ultrasound of the testicle can show whether blood flow is normal and also help the doctor evaluate its degree of twist. For instance, if it becomes completely twisted there would likely not be any blood flowing through and no smooth surface would exist on its spermatic cord.
If the doctor cannot save an affected testicle, he will surgically extract it through orchiectomy. Although this may affect self-image for boys who undergo this process, most who have one testicle removed are still able to become parents in future years. They should refrain from engaging in strenuous physical activities and sexual activity until they’re older, using a condom when engaging in sexual activity with another man or having sexual relations with them. Surgery sites may ooze for several days following an operation, but staying active and walking will increase blood flow to the site and speed recovery. A physician will advise when your son can resume his usual activities; in the meantime, resting and sleeping as much as possible should help him to recover quickly. A hot shower or bath may also prove beneficial.
Treatment
Testicular torsion occurs when one testicle rotates inward, twisting its spermatic cord which brings blood from the scrotum into it and cutting off blood flow to it, leading to sudden and severe pain and swelling. If left untreated immediately, this condition could become fatal – and result in decreased fertility or infertility for some individuals.
Persons experiencing symptoms of testicular torsion should contact their healthcare provider or go directly to an emergency room (ER), where they should lie on their back with one leg raised and a pillow under the other for support. Healthcare providers will then use an ultrasound machine to check if either testicle has become twisted. They may also inquire whether any sexual activity has taken place recently as sexual stimulation can contribute to testicular torsion.
Doctors typically can save and untwist testicles that have not become severely torsioned, provided their torsion isn’t too severe. Patients will typically be given painkillers and general anesthesia prior to surgery to ensure no discomfort while having it done; doctors then make a small cut in the scrotum, unwind the cord, and stitch back up afterwards in order to prevent future torsions.
Even if the testicle pain goes away on its own, it’s still important to notify a parent or physician immediately as any torsion could have just untwisted and then retwisted itself without treatment. Too long twisted testicles could become permanently damaged and need to be surgically removed from their testicles in order to preserve health and safety.
If the doctor is unable to save an affected testicle, a surgery called orchiectomy might be required to remove it. Most boys can still father children after having one removed and often can receive an artificial one later as part of treatment.
Healthcare providers typically advise their patients to avoid vigorous physical activities and sexual activity for several weeks following surgery before making a determination on resuming these activities. They may also require them to wear underwear that doesn’t cover up their genital area so as to not accidentally twist or torsion their testicle again and cause another episode.
Prevention
Testicular torsion can only be prevented through immediate treatment. If you or your son experience intense groin pain, don’t wait – that pain could be your body’s way of telling you something serious is wrong and needs immediate fixing.
Your body provides blood to your testicles through two spermatic cords (also called testicular cords). These long, thin tubes run from inside of your scrotum down to each testicle and attach at its base to a top scrotal sac; if you rotate your testis in your scrotum, tissues around its testicle may loosen, twisting your spermatic cord and cutting off its blood supply to it – without it getting oxygen, the testicle may shrink and die; doctors usually save these testicles provided they’re untwisted within four hours after starting symptoms appear.
Testicular torsion is more likely to happen in cold weather and among athletes who practice tight-fitting sports such as those using tight shorts and pants for practice. People who lie down for extended periods, such as while sleeping, also increase their risk for testicular torsion.
Rarely, people born with twisted testicles may develop them before birth – this makes it impossible to save the affected organ.
Doctors can diagnose testicular torsion by performing an ultrasound and blood or pee test, both using high-frequency waves to create an image of the testicle and monitor blood flow, with pee or blood tests ruling out other potential causes, such as infection. An orchiopexy procedure is used to repair torsion; it involves sewing the testis into place inside of the scrotum. After surgery, your son should avoid strenuous activities as well as sexual activity for some time after returning home from hospital; consult his physician as to when he can resume normal activities and resume fatherhood plans if appropriate.
