Testicular Torsion: Symptoms, Causes & Treatment

Testicular torsion is a very urgent medical emergency that occurs when the spermatic cord (the cord carrying the blood vessels supplying the testicle) twists, so this twisting cuts off or severely reduces blood flow to the testicle. Since testicular tissue is very sensitive to lack of blood supply, continued torsion without treatment for a few hours may lead to death of the testicular tissue and its permanent loss. For this reason, testicular torsion is among the most important emergency surgical conditions that tolerates no delay.

Testicular torsion occurs most in adolescents and young men, but may affect any age including newborns. It may occur suddenly without a clear cause, or after physical activity or an injury, and often wakes the patient from sleep. The most prominent sign is sudden, very severe pain in one of the testicles, usually accompanied by swelling and redness of the scrotum, the affected testicle rising or changing position, nausea and vomiting, and sometimes lower abdominal pain. It is very important not to confuse testicular torsion with other less dangerous causes of testicular pain, so when in doubt it must always be treated as an emergency.

Testicular torsion is a race against time, as the chance of saving the testicle is very high if treated surgically within the first few hours of pain onset, and this chance decreases greatly the longer the delay. Therefore, any sudden severe testicular pain should prompt taking the person to the emergency department immediately without waiting or attempting home treatment. It is diagnosed by clinical examination and often Doppler ultrasound to assess blood flow, but imaging must not delay surgery when suspicion is strong. Treatment is urgent surgery to untwist the cord, restore blood flow, and fix the testicle to prevent recurrence, and the other side is often fixed preventively. The most important awareness message: do not ignore sudden testicular pain or wait for it to go away on its own.

• Sudden, very severe pain in one of the testicles.
• Swelling and redness of the scrotum and the testicle rising or changing position.
• Nausea and vomiting, and sometimes lower abdominal pain.
• Often wakes the patient from sleep.

• Twisting of the spermatic cord cutting off blood flow to the testicle.
• May occur suddenly without a cause, or after physical activity or an injury.
• Most common in adolescents and young men, and may affect newborns.

• Urgent clinical examination of the scrotum and testicle.
• Doppler ultrasound to assess blood flow.
• Imaging must not delay surgery when suspicion is strong.

Urgent surgery (a race against time)

• Untwisting the cord and restoring blood flow within the first few hours saves the testicle.
• Fixing the testicle to prevent recurrence, and often fixing the other side preventively.

The chance of saving the testicle decreases sharply with every hour of delay. No home treatment — go to the emergency department immediately. This content is educational and does not replace emergency care.

• Permanent loss of the testicle with delayed treatment.
• A possible effect on fertility.
• Possibility of recurrence on the same or other side if not fixed.

• Torsion often cannot be prevented, but quickly seeking emergency care saves the testicle.
• Surgically fixing the testicle prevents recurrence.
• Awareness of not ignoring sudden severe testicular pain.