Understanding Testicular Torsion

Testicular torsion is a serious condition that is seen most often in adolescent boys and young men. Testicular torsion is the twisting of the spermatic cord, which can cut off the blood supply to the testicle and cause permanent damage. The spermatic cord connects the testicle to the reproductive organs and contains blood vessels, nerves, and vas deferens, which is the tube that carries sperm.

Testicular Torsion _FINALWhile not common, testicular torsion causes severe pain and requires immediate medical attention and possible emergent surgery to untwist the spermatic cord and prevent permanent damage to the testicle.


Symptoms of Testicular Torsion

  • Severe and sudden pain on one side of the scrotum due to lack of blood flow is often the first and most common symptom of testicular torsion.  
  • Swelling and redness on the affected side of the scrotum often accompanies the onset of pain.

  • Abdominal pain.

  • Nausea and/or vomiting associated with the severe pain.

Testicular torsion is an emergency as loss of blood flow to the testicle for a period of just hours can cause the testis to die or be permanently damaged.

Surgery to correct the twisted spermatic cord is often indicated. Torsion can result in problems with fertility later for men who do not seek immediate medical treatment by a urologist. If you experience sudden and severe pain in your scrotum, go to the closest emergency room for evaluation and treatment.


What Causes Testicular Torsion?

Testicular torsion is not a common problem in men. The condition most often affects younger males and adolescents, although it can happen at any age. Torsion typically occurs only on one side of the scrotum. The causes of testicular torsion can be somewhat vague but may include:

  • Weakened tissues that hold the testicles to the scrotum. When the testicle is not supported inside of the scrotum, it can rotate around the spermatic cord and cause the twisting.

  • A family history or inherited trait that allows the testes to rotate in the scrotum.

  • Injury to the testicles.


Diagnosing Torsion

Immediately after presenting with symptoms of torsion, your doctor will perform a physical exam of the scrotum, groin area, and testis, and ask you questions about your pain and onset of symptoms. If the pain you are feeling is not clearly torsion, your doctor may order other tests to confirm the diagnosis including an ultrasound of the scrotum to check blood flow in the spermatic cord and to the testicles.

Patients who present with severe pain and swelling of the testis may need an emergency surgical procedure to untwist the spermatic cord and restore blood flow to the testis. Time is of the essence when the goal is to save the testicle from irreparable damage.



Surgery is almost always the treatment for testicular torsion and is necessary to untwist the spermatic cord and restore blood flow to the testicle. To save the affected testis, surgery within five or six hours of onset of symptoms is recommended to try to prevent permanent damage. In cases of torsion that have gone untreated for more than 12 to 24 hours, complete removal of the affected testicle, called an orchiectomy, may be necessary if the damage to the testicle is irreparable.  

  • Surgery for torsion is typically performed under general anesthesia and can be performed either in the hospital or in one of Chesapeake Urology’s Summit Ambulatory Surgery Centers.

  • The surgeon makes a small incision in the scrotum to access the spermatic cord and testis to untwist it and restore its proper placement. Your surgeon will usually stitch the testicle to the inside of the scrotum to ensure torsion does not occur again.

  • The testicle on the other side is usually fixed with stitches as well to prevent similar occurrence in the future.

  • Following surgery, you may need to take pain medication for several days to control any mild discomfort at the surgical site.

  • Recovery requires rest and it is recommended that you avoid strenuous exercise for several weeks following the procedure. Patients typically return to other normal daily activities within one week.


Testicular Torsion in infants and boys

While very uncommon, testicular torsion can occur in newborns, infants and young boys. In cases of pediatric testicular torsion, the specialists at Chesapeake Urology’s pediatric urology program – Chesapeake Urology For Kids – are experienced in the diagnosis and treatment of torsion in children.

Learn more by visiting http://forkids.chesapeakeurology.com/.


Find a Chesapeake Urology doctor - Visit http://www.chesapeakeurology.com/physicians/.