December 22nd, 2015
Testicular torsion is a surgical emergency, so it’s important to recognize. The spermatic cord contains blood vessels that supply the scrotum. In testicular torsion, the testicle rotates, twisting the spermatic cord and interrupting the blood supply. The causes aren’t entirely clear. Many men who experience testicular torsion have an inherited predisposition to the trait that may affect both testicles. Other associated factors are vigorous physical activity and rapid growth of the testicle during puberty, although torsion can occur after a minor injury or during sleep. It occurs most commonly in males between the ages of 12 and 16. Men who have had a previous episode are more likely to have testicular torsion occur again. Finally, if your family history includes testicular torsion, you are at higher risk.
Symptoms of testicular torsion include swelling the scrotum and sudden severe pain in the scrotum and groin. Many men experience abdominal pain, nausea, and vomiting. The testicle may be positioned higher than normal, particularly when compared to the other testicle. Sometimes, the testicle appears to lay at an unusual angle. Fever and painful urination sometimes accompany the condition, but can also be a symptom of other genitourinary tract problems. Parents of young boys should be aware that they may wake up with scrotal pain during the night.
Men with signs and symptoms of testicular torsion should seek emergency care immediately. After approximately six hours, testicular tissue begins to die, which has an impact on male fertility. In men who don’t seek treatment, removal of the testicle is the likely outcome.
Men or boys who have had episodes of testicular pain that resolves without treatment may be experiencing intermittent torsion with detorsion, as the testicle moves on the axis of the spermatic cord. If you have experienced any testicular pain, even if resolved, you should see a urologic surgeon for evaluation. Surgical intervention can prevent further episodes of torsion.
Any episode of testicular pain should prompt you to seek immediate medical care. In many cases, surgery is necessary to save the testicle. Since the condition most often occurs in young men, fertility is an important consideration. After six hours of torsion, the opportunity to save the testicle diminishes. If you experience these symptoms, seek immediate care. If you have experienced intermittent testicular pain, you should consult a urologist to determine the cause. If you are experiencing intermittent torsion, then a surgical procedure performed electively can prevent further episodes and associated complications.
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