Torsion Testis: Symptoms, Causes, Diagnosis, and Treatment

A testicular torsion is a condition when the testicles or testicles spin, then twist a set of fibers and tissues (spermatic cord) that carry blood to the scrotum. This reduced blood flow causes sudden pain and swelling. Torsion testis most often occurs between the ages of 12 and 18 years, but this condition can occur at any age.

What Is a Torsio Testicle?

A cord or cord known as a spermatic cord carries blood to the testes. During the testicular torsion, these cords rotate and cause blood flow and tissue in the testicles to die.

Torsion testis usually requires emergency surgery. But if treated quickly, the testicles can usually recover. But when the blood flow has been interrupted for too long, the testes may become damaged and must be removed.

Symptoms of Torsion Testicles

Pain and swelling of the testicular sac (scrotum) are the main symptoms. The onset of pain can be very sudden and the pain can be severe. Swelling may be limited to one side or can occur throughout the scrotum.

Other signs and symptoms of torsion testis that can accompany, include:

  • Stomach ache
  • Nausea and vomiting
  • On palpation, the testis is higher than the normal adjacent testis
  • Frequent urination
  • Fever.

Young boys who have this condition usually wake up because the scrotum can get sick in the middle of the night or early morning.

When is the Right Time to See a Doctor?

Immediately to the doctor if the testicles feel sudden or severe pain. Immediate treatment can prevent testicular damage. You also need to seek medical help if you experience sudden testicular pain that goes away without treatment. This can occur when the testes rotate and then release themselves (intermittent torsion and detorsion). Surgery is often needed to prevent problems from happening again.

Causes of Testicular torsion

Until now the conditions that cause the testicles to spin are not known with certainty. In some cases, a man who has this condition has an inherited trait that allows the testicles to rotate in the scrotum. This congenital condition often affects both testicles.

This condition also often occurs several hours after strong activity, after a minor injury to the testicles, or while sleeping. Cold temperatures or rapid growth of the testicles during puberty may also play a role.

Risk Factors

  • Age. Torsion testis most often occurs between the ages of 12 and 18 years.
  • Previous condition. If you have testicular pain that goes away without treatment, it is likely that this condition will occur again. The more frequent pain attacks, the higher the risk of testicular damage.
  • Family history. This condition can occur if there are family members who have a history of torsion testis.

Torqueo Testis Diagnosis

The doctor will ask you to verify whether the signs and symptoms are caused by torsion testis or something else. Doctors often diagnose this condition with a physical examination of the torsion testis by examining the scrotum, testicles, stomach, and groin.

In addition, the doctor can also test the reflex by rubbing lightly or pinching the inside of the thigh on the affected side. Usually, this method causes the testicles to contract. This reflex may not occur if you have torsion of the testes.

Sometimes medical tests are needed to confirm the diagnosis or to help identify other causes of symptoms that appear, including:

  • Urine test. This test is used to check for infection.
  • Scrotal ultrasonography. This type of ultrasound is used to check blood flow. Decreased blood flow to the testes is a sign of interference.
  • Operation. Surgery may be needed to determine whether symptoms are caused by another condition.

If you feel pain for several hours and a physical examination shows symptoms, you might go straight to surgery without additional tests. Delaying surgery can cause loss of the testicles.

Treatment of torsion testicles

Torsion testis is a condition that requires surgery. In some cases, the doctor may be able to unravel the testicles by pushing the scrotum (manual detorsion). Surgery is needed to prevent this condition from happening again

Surgery is usually done with general anesthesia. During surgery, the doctor will make a small incision in the scrotum, remove the spermatic cord (if needed), and sew one or both testicles into the inside of the scrotum.

The faster the treatment after the testicles are twisted, the greater the chance of being saved. After six hours from the beginning of the pain, the possibility of needing the removal of the testicles is greatly increased. If treatment is delayed more than 12 hours from the start of the pain, a 75 percent chance requires removal of the testicles.

Torsion Testicles in Newborns and Toddlers

Although rare, this condition can occur in newborns and toddlers. The sign can be seen from the hard, swollen, or darker testicles. Ultrasonography may not detect reduced blood flow to the baby’s scrotum, so surgery may be needed to confirm the condition.

Please note, the treatment performed on infants is still controversial. If a boy is born with torsion and testicular symptoms and symptoms, it may be too late for emergency surgery because of the risks associated with anesthesia.

However, emergency surgery can sometimes save all or part of the testis and can prevent torsion in other testes. Treatment as a baby can prevent future problems related to the production and fertility of male hormones.

Complications of Torsion Testicles

Torsion testis is an emergency that requires immediate treatment. When not treated quickly, this condition can lead to severe complications. Here are some complications that can occur, including:

  • Infection

If dead or badly damaged testicular tissue is not removed, gangrene can occur. Gangrene is a potentially life-threatening infection. This condition can spread rapidly throughout the body and cause shock.

  • Infertility

If damage occurs to both testicles, infertility will occur. However, if you lose one testicle, your fertility will not be affected.

  • Transformation

The loss of one testicle can create deformities that can interfere with self-confidence. However, this can be overcome by inserting a testicular prosthesis.

  • Atrophy

This condition causes the size of the testicles to shrink significantly. Testicles with atrophy cannot produce sperm.

  • Broken testicles

If left untreated for more than a few hours, the testes can be damaged, so they need to be removed. Testicular conditions are fairly safe if treated four to six hours after the pain appears.

After 12 hours, there is a 50 percent chance of saving the testes. After 24 hours, the chance of saving the testes drops to 10 percent.

Prevention of Torsion Testicles

Having a testis that can rotate or move back and forth freely in the scrotum is inherited. there are men who have this condition while others don’t.

The only way to prevent this congenital condition is through surgery if you have experienced this before, by attaching both testicles to the inside of the scrotum so that they cannot rotate freely.


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