The testicles are male reproductive organs that are present in a sac called the scrotum. They receive blood supply from a cord called the spermatic cord which is present on both sides. Twisting of this cord results in a painful condition called testicular torsion. This usually occurs on one side and is an emergency condition as the blood flow to the testicle is compromised and it begins to die. It is a rare condition that typically affects adolescent males.
Testicular torsion usually affects only one side and may be caused by weakness of the supporting tissues that surround the testicles, allowing free movement, which can increase the chances of the cord becoming twisted. Injury to the groin and rapid growth during puberty are also causes.
Testicular torsion is usually accompanied by sudden pain and swelling. One testicle may appear higher than the other. Other symptoms include nausea, vomiting, dizziness, a mass in the scrotum and blood in the urine. The twisted cord may sometimes untwist on its own, but the condition often recurs and requires medical investigation.
If you are experiencing testicular pain, you must seek help immediately. Delaying treatment for more than six hours can severely compromise the health of the testicle. Your doctor will examine your scrotum and any swelling present. Urine tests are performed to rule out infection. Imaging tests such as an ultrasound may be performed to visualize the testicle and its blood flow.
Testicular torsion is treated emergently to restore blood supply to the testicle and prevent tissue death. Untwisting of the cord can occasionally be performed manually by your doctor, but usually requires surgical intervention. Surgical detorsion is performed under general anaesthesia and involves making an incision in the scrotum, untwisting the spermatic cord, and securing the testicle with sutures to prevent recurrence. If intervention is delayed, your doctor will examine the viability of the testicle and may sometimes remove it. Early presentation usually results in a favourable outcome.