Testicular Torsion

Testicular Torsion: A Painful Medical Emergency
Perhaps the most common testicular problem is torsion of a testicle. This condition usually occurs in childhood and the teenage years, but can occur in men of any age. Some men are predisposed to testicular torsion as a result of inadequate connective tissue within the scrotum itself, but testicular torsion can happen to anyone with testicles.

The term “torsion” actually refers to impaired blood flow. The impaired blow flow occurs when a testicle twists around on the spermatic cord, which carries the spermatic artery, and cuts off its own blood supply.

Testicular torsion can actually happen spontaneously and for no apparent reason. Sometimes it even occurs during sleep. Oddly enough, the cord can untwist by itself before you get to a urologist or other health-care provider. However, if it happened to you once, you are most likely at risk for it to occur again, and most urologists would probably recommend surgery to repair the testicle, or both testicles.

In adult men, testicular torsion is often a result of trauma to the scrotum, or of strenuous physical exertion. For example: A softball, baseball, or golf ball hits a man hard in the scrotum and causes the torsion. (I had a patient who was the victim of a hard-hit softball to his groin.) Being kneed or kicked in the testicles can also cause testicular torsion. The pain of torsion is actually worse than the kick that causes it, so hopefully you will know not to ignore this! (Ouch! And I’m a woman.)

Nausea, vomiting, and dizziness are often present when there is an absence of blood supply to the testicle, or if the injury is sudden. Fainting can also occur.

Testicular torsion is considered a medical emergency and usually requires surgery within 4 to 6 hours if the testicle is to be saved. An ultrasound of the scrotum most often confirms this diagnosis by showing the absence of blood flowing to the testicle.


A surgeon, or urologist, sometimes will stitch the testicle in place so the torsion doesn't reoccur. If the condition is diagnosed quickly and corrected immediately, the testicle may continue to function properly.


After 6 hours of torsion, the chances that the testicle will need to be removed increase. The testicle may sometimes lose its ability to function even after less than 6 hours of torsion. (Remember, you only need one testicle to produce testosterone and to father a child. Testosterone is also produced by the adrenal glands.)


How will you recognize this situation? As the testicle's blood supply is reduced, it gradually turns red, then purple and eventually blue. That’s when the pain becomes excruciating and medical help is essential.


When engaging in any sport that involves a fast-moving object, guys should either wear a cup or avoid trauma to the scrotum (in other words, never play goalie, catcher or pitcher without a cup).

Remember, this condition is a surgical emergency. If symptoms of testicular torsion occur, seek emergency treatment promptly. Call 911 in the United States if you are in too much pain to drive. Somehow, get to your nearest emergency room.


Regardless of your age, if you have the aforementioned symptoms, seek medical attention promptly