What is testicular torsion?
Torsion is a medical emergency that occurs when the spermatic cord twists and blocks blood flow to and from the testicle. The spermatic cord is a collection of structures that attaches to the testicle, and it provides the blood supply. When the testicle twists, it blocks the venous blood flow out of the testicle, causing it to swell, and subsequently blocks the arterial blood flow into the testicle as well(1). This means that in a matter of hours, the testicle can become ischemic due to a lack of oxygen and blood flow, and die. If caught early, torsion is very treatable!
How do you recognize it?
The most important symptom to look out for is sudden, severe testicular or scrotal pain(2). It usually only occurs on one side, and may radiate to the groin as well. Other common symptoms include nausea, vomiting, and abdominal pain(2). On examination, the testicle will likely be tender, and may appear red, swollen, or elevated.
Who is at risk?
While testicular torsion can affect anyone with testicles, it is most common in people aged 12-18(3).
What should you do about it?
If you suspect torsion, seek medical attention ASAP. Go to your local emergency department as quickly as you can. In order to save the testicle, medical intervention is required within 4-6 hours of the start of symptoms(4).
Don't delay, make the call instead of losing your ball.
(1) Zvizdic Z, Aganovic A, Milisic E, Jonuzi A, Zvizdic D, Vranic S. Duration of symptoms is the only predictor of testicular salvage following testicular torsion in children: A case-control study. The American Journal of Emergency Medicine. 2021 Mar 1;41:197-200.
(2) Pogorelić, Zenon, Ivana Mrklić, and Ivo Jurić. "Do not forget to include testicular torsion in differential diagnosis of lower acute abdominal pain in young males." Journal of pediatric urology9.6 (2013): 1161-1165.
(3) Greear GM, Romano MF, Katz MH, Munarriz R, Rague JT. Testicular torsion: epidemiological risk factors for orchiectomy in pediatric and adult patients. International Journal of Impotence Research. 2021 Mar;33(2):184-90.
(4) Shergill IS, Foley CL, Arya M, Bott SR, Mundy AR. Testicular torsion unravelled. Hospital Medicine. 2002 Aug;63(8):4
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