Testicular Torsion – What It Is and What You Need to Do

Testicular torsion is a surgical emergency that occurs when the spermatic cord, the duct that travels within the scrotum, becomes kinked or wrapped around a testicle. The blood supply to the testicle is interrupted, resulting in severe pain from lack of oxygen. Testicular torsion most commonly occurs among teenage males. It is the most common medical emergency affecting the male genitalia. Without rapid care, the cells in the testicular tissue will begin to die.

Although it may seem that the testicles float freely within the scrotum, they are actually anchored to the base of the scrotum by a tract of tissue known as the gubernaculum. The gubernaculum keeps the testicle from twisting or kinking the spermatic cord. Most cases of testicular torsion result from a congenital condition, which means a condition present at bir

th. In these cases, the gubernaculum is missing or defective, a condition known as a “bell-clapper” deformity. In men with this condition, torsion can occur simply by changing position during sleep. Men who have a normal gubernaculum can also experience testicular torsion when the gubernaculum becomes damaged or torn by accidental impact or trauma to the scrotum during sports or other physical activity.

Treatment of Testicular Torsion

In testicular torsion, immediate surgery is almost always required. There is a 6-hour period before the testicular tissue begins to die. During surgery, the surgeon enters the testicle through a small incision to release the spermatic cord. After untwisting the cord, the surgeon is able to use stabilize the testicle’s position with sutures to prevent another episode of torsion.

The procedure is usually very effective if the intervention is timely. Most men who receive help in time are able to save the testicle. However, the chance of recovery diminishes as time passes without treatment. At forty-eight hours after torsion, 90 % of patients who have not been treated will require removal of the affected testicle. Parents should be especially alert if their male child or infant is experiencing pain in the groin area, since loss of the testicle can impact fertility later in life. Adolescent boys are sometimes embarrassed to report the pain until it becomes unbearable, which causes a delay in treatment that could prevent effective intervention. In the case of testicular torsion, timely treatment is everything.