Testicular torsion is a medical emergency that must be addressed immediately. This condition occurs when your spermatic cord twists around itself, blocking blood flow to one of your testicles.
Your testicle needs emergency surgery as soon as possible in order to protect it from permanent damage, but first you will require some medical tests.
Symptoms
The scrotum, the pouch that hangs beneath the penis, houses two testes (plural of testis), connected by blood vessels to other areas of the body. If an individual experiences testicular torsion, their spermatic cord becomes twisted and cuts off blood flow to an affected testicle, necessitating immediate medical treatment; otherwise severe damage or even loss could ensue if treatment is delayed beyond six hours.
Torsion of the testis can be identified by sudden and intense pain in both the scrotum and one testicle (usually the left). This pain can often be described as either sharp or throbbing and may also include nausea or vomiting. Emergency care must be sought immediately in such instances because this indicates blood supply has been cut off to that testicle and it will die without intervention.
Testicular torsion can sometimes involve both testicles at once. When this happens, it is vitally important that they quickly locate which testicle has been affected before heading towards medical assistance as quickly as possible.
Epididymitis can also be mistaken for testicular torsion; its symptoms involve swelling and tenderness in both testicles due to infection of the epididymis gland. Unfortunately, epididymitis’s signs and symptoms tend to be less acute and more diffused than testicular torsion’s, making it hard to distinguish one from the other.
If a patient experiences severe testicular torsion pain, physicians must immediately rule out a hematoma by conducting a scrotal ultrasound exam. An ultrasound exam can help doctors establish whether there is indeed a hematoma present by comparing its appearance with that of the painful testicle.
In cases of suspected testicular torsion, physicians should perform a radionuclide scan using 99mTc to assess blood flow to the area and identify any areas requiring urgent surgery. While this technique provides useful insight, it does not replace clinical diagnoses of torsion.
Diagnosis
Testicular torsion symptoms usually include severe pain in one testicle with swelling of the scrotum, nausea or vomiting and possible bleeding from either testicle.
If a patient experiences these symptoms, medical attention must be sought immediately. Testicular torsion is a medical emergency that should be addressed quickly in order to increase its chance of successful recovery and save the affected testicle.
Torsion occurs when a man twists his testicle, twisting its spermatic cord inside. This can hinder or cut off blood flow to his testicle and cause it to swell up and become painful, leading to slow or no blood supply to his testicle causing swelling and pain.
Torsion may lead to irreparable damage of both testicles and the spermatic cord, decreasing their fertility significantly or even leading to infertility altogether. If left unchecked, torsion may even result in permanent infertility in men.
Emergency room healthcare providers take an in-depth patient history and conduct a physical exam, and often also recommend ultrasound. Scrotal ultrasound may reveal whether the testicle has become twisted and lost blood circulation; additionally, it may reveal whether its cord has become tangled inside of their bodies – visible through their skin or otherwise.
Sperm count may decline if blood supply to the testicle is interrupted for too long, making treatment immediately essential to maintaining health. Your physician will usually attempt to manually untwist and unwrap spermatic cord in order to restore blood flow to testicular.
Ultimately, if the doctor cannot untwist the spermatic cord on their own, emergency surgery may be required in order to secure torsion in future episodes. Attaching the affected testicle directly to the scrotum could help stop further torsion from recurring in future years.
Bell clapper deformity is one of the primary risk factors for testicular torsion, in which one or both testicles is not attached to his scrotum, increasing chances of testicular injuries like torsion or hematoma. When necessary, our urologists may perform an orchidectomy as an outpatient procedure and connect either or both testicle at risk during this process.
Treatment
Primary treatment goal should be the preservation of the testicle. Early diagnosis increases chances of complete salvage (though complete salvation after 8 hours is unlikely). Symptoms usually appear suddenly and intensely, often with loss of cremasteric reflex, along with pain and swelling that spreads beyond just the testis, to include the scrotum and inguinal regions.
Urologists (doctors who specialize in urinary tract and male reproductive system issues) often advise their patients with symptoms indicative of testicular torsion to seek emergency surgical exploration as soon as possible; four to eight hours exists before permanent ischemic damage sets in.
Testicular torsion must be distinguished from other causes of painful scrotum conditions, such as infectious epididymitis and orchitis, through proper diagnosis. A urinalysis can assist, including testing for both Gonorrhea and Chlamydia infections; however, definitive diagnoses of torsion require clinical and physical exams.
At first, ultrasound should be your main diagnostic tool. It allows for thorough examination of both scrotum and testicles as well as assessment of blood flow to the testis. When performed bilaterally, it’s most useful in comparing painful testicles with unaffected ones – often enlarged and hypoechoic with decreased blood flow while unaffected testicles have normal size and appearance.
Other tests cannot help in diagnosing testicular torsion, with radiographs providing the only definitive evidence. When radiographs reveal a mass displacement, immediate evaluation and management should occur to help preserve and save a testicle – as early intervention increases its chance of recovery.
An individual suspected of torsion should be placed into the supine position immediately to reduce further blood loss from their testicle, start receiving IV fluids immediately and remain NPO until surgery. Detorsion surgery is often necessary; manual attempts at emergency operative care may lead to further worsening since rotating laterally increases testicular twisting (the “bell clapper effect”). For best results, orchiopexy should be performed by a trained urologist as this will reduce future risks of torsions.
Recovery
Testicular torsion is a medical emergency requiring immediate attention in order to avoid permanent damage or loss of a testicle. Torsion occurs when the spermatic cord that connects to the testicle becomes twisted, cutting off blood flow to it and causing swelling. Surgery is needed in order to untwist it and restore blood flow back into it – otherwise the testicle could die and require removal (known as orchiectomy). For optimal outcomes it’s vitally important that treatment begin as quickly as possible so as not risk permanent damage or loss – don’t leave this decision until too late! Torsion must be addressed promptly so as not permanently damage can be avoided and maximize chances for saving this testicular organ!
Health care providers who suspect testicular torsion will conduct a physical exam and ask about your symptoms, along with an ultrasound of the scrotum and testicles. A radionuclide scan called 99mTc scrotography may also be done to detect low blood flow to each testicle to confirm diagnosis.
Testicular torsion symptoms typically manifest themselves with sudden, severe pain in the scrotum or abdomen during middle school or early adulthood adolescence or adulthood. The pain can be sudden and sharp; in severe cases it can even cause nausea or vomiting. Furthermore, the area afflicted often swells up reddens up quickly while becoming warm to touch.
Sometimes the pain eases off on its own or with medication, signaling that your testicle hasn’t become twisted and needs attention. But if the pain remains intense or doesn’t go away quickly enough, it could mean your testicle has twisted and isn’t receiving enough blood supply to function normally. If this is the case for you, however, seek medical advice immediately as an infection could occur without warning.
Most individuals diagnosed with testicular torsion should undergo emergency surgery immediately. If left untreated within six hours, testicles can die and need to be surgically removed, leading to infertility or incapacitation.
After surgery, it’s essential that you rest and limit sexual activity for several weeks afterward in order to help avoid future testicular torsion recurrences. You should also undergo regular testing for signs of recurrence; should any be detected, your physician will likely suggest different treatment plans.
