Testicular torsion is a medical emergency in which a male's spermatic cord (which holds the testicle in place inside the scrotum) twists, cutting off blood supply to the testicle.
Testicular torsion occurs when the spermatic cord twists. The spermatic cord supplies blood to the testicle and houses the duct that carries sperm from the testicle to the urethra. The cord starts in the abdomen and extends into the scrotum, attaching to the testicle. Testicular torsion usually only happens on one side, although rarely it can occur on both sides.
Testicular torsion is not a common problem; it occurs in about 1 in 4,000 men and boys under age 25. It can occur during the first year of life (infancy) and at puberty (the beginning of adolescence).
Testicular torsion can be the result of defects in the connective tissue * in the scrotum. When this happens, the problem often becomes apparent during infancy. It can also occur following injury to the groin or after heavy exercise (e.g., weight lifting) that causes scrotal swelling.
Testicular torsion is a problem of boys and men. Some children are born with an inherited condition that causes the testicles not to attach properly to the scrotum.
Signs of torsion of the testicle are sudden severe pain on one side of the scrotum, swelling within the affected side of the scrotum, nausea and vomiting, and faintness. The scrotum may change color, becoming red or darkening. Additionally, a boy or man may feel a lump in the affected testicle and see blood in the semen.
The healthcare provider obtains a health history asking questions about symptoms experienced, specifically: When did the pain occur? What was the person doing when the pain occurred? Physical examination indicates swelling and extreme tenderness in the testicle. The testicle on the affected side is higher in the scrotum than the unaffected testicle. An ultrasound * of the testicle is done to determine if blood flow is affected. If the torsion is complete, blood flow will be completely cut off; if the torsion is partial, some blood will flow to the testicle. Blood or urine tests can help make sure the problem is not from an infection instead of torsion.
Many cases of testicular torsion cannot be prevented. However, testicular torsion associated with injuries to the groin can be prevented by wearing appropriate protective gear when participating in sports.
See also Epididymitis • Puberty and Sexual Development • Scrotal Swelling
Parsons, John Kellogg. Handbook of Urology. Hoboken, NJ: Wiley, 2013.
MedlinePlus. “Testicular Torsion.” U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000517.htm (accessed April 4, 2016).
Urology Care Foundation. “What Is Testicular Torsion?” http://www.urologyhealth.org/urologic-conditions/testicular-torsion (accessed April 4, 2016).
Urology Care Foundation. 1000 Corporate Blvd., Linthicum, MD 21090. Telephone: 410-689-3700. Website: www.urologyhealth.org (accessed April 4, 2016).
* connective tissue is tissue that connects, supports, binds, or separates other tissues or organs.
* ultrasound is a diagnostic test in which sound waves passing through the body create images on a computer screen. Also called a sonogram.
* infarction (in-FARK-shen) is the obstruction of the blood supply to an organ or area of tissue resulting in death of the tissue.