Wednesday, October 23, 2019

Testicular Torsion: Causes, Symptoms, Diagnosis & Treatment

What is testicular torsion?
Testicular torsion is a condition in which testicle rotates causing the twisting of the spermatic cord that brings blood to the scrotum. Twisting of spermatic cord affects blood flow and the tissues in the testicle begin to die. The reduced blood flow causes sudden and severe pain and swelling.

Testicular torsion is most common between ages 12 and 18. This condition is rare and affects only about 1 in 4,000 under the age of 25. Bilateral torsion is a condition in which both testicles are affected but it happens rarely. If testicular torsion is treated early then the testicles can be saved. But if blood supply is cut for long time then testicle might become so badly damaged that it has to be removed.

(2) What testicular torsion feels like? How do you check for testicular torsion?

How do I check myself for testicular torsion?
If you have a testicular torsion, you may feel a sudden and severe pain in your testicles and scrotum. You may also feel swelling. Your doctor conducts a physical exam of the scrotum, testicles, abdomen and groin. He/she may also pinch or rub your thighs near affected area. This test is used to check your reflexes.

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(3) What causes testicular torsion? What is the main cause of testicular torsion?

Major Causes of testicular torsion:

Many of those who have testicular torsion are born with a higher risk for the condition, although they may not know it. It happens if the testicle rotates on the cord that runs upward from the testicle into the abdomen. The rotation twists the spermatic cord and reduces blood flow. Frequent rotation can block the blood flow entirely, causing damage more readily. Some major causes of testicular torsion as described under:

  • (1) Any vigorous activity or a minor injury to the testicles may lead to testicular torsion.
  • Sports injury or an injury to the groin may cause testicular cancer also.
  • (2) About 10% of testicular torsion cases have a family history of the condition. Testicular torsion can run in families, affecting multiple generations as well as siblings.
  • (3) Cold temperature or rapid growth of the testicle during puberty may cause testicular torsion.
  • (4) Testicular torsion can occur while you’re sleeping due to twisting of testicles.
  • (5) Most males have an inherited trait that allows the testicle to rotate freely inside the scrotum.
  • (6) People who have weaker connective tissue in the scrotum are more susceptible to torsion of testicles.
  • (7) Bell clapper deformity is a congenital trait that can move your testicles more freely in the scrotum. This movement increases the risk of the spermatic cord twisting hence leading to torsion cases.

(4) What are the symptoms of testicular torsion?
Signs and symptoms of testicular torsion:

  1. Abdominal pain
  2. Blood in the semen
  3. Fever
  4. Dizziness
  5. Vomiting
  6. Frequent urination
  7. Lumps in the scrotal sac
  8. Swelling of the scrotum
  9. Nausea
  10. Sudden, severe pain in the scrotum

(5) Does testicular torsion hurt to touch?

Can a twisted testicle kill you? Can you die from testicular torsion?
Testicular torsion is a serious condition that can slow or cut off blood flow to the testicle.
If blood flow isn't restored it makes the affected testicle swell up and become painful. You may feel a sudden and severe pain in scrotum and one of testicles.

Testicular torsion is a medical emergency that needs to be fixed as quickly as possible to prevent infertility and other complications. Delay in treatment can cause the testicle to die approximately within 6 hours of testicular torsion. After a period of 12 hours, there are mere 50% chances of saving the testis however after 24 hours, the chances of saving the testicle drop to just 10%.

(6) How do you untwist testicular torsion?

How do you fix a twisted testicle?
In manual detorsion, your doctor may be able to untwist the spermatic cord by hand. However in most cases, orchiopexy or surgery is performed to restore blood flow to the testicles. During surgery, your doctor will perform the following procedures:

  • Make a small cut in your scrotum,
  • Untwist your spermatic cord,
  • Stitch one or both testicles to the inside of the scrotum.


(7) Will you die if your balls get cut off?
Without testicles:

  • You will be unable to father children,
  • You will be infertile,
  • Libido or desire for sex, will disappear,
  • You will no longer produce testosterone,
  • You will not produce sperm.

(8) What is intermittent testicular torsion?
Intermittent testicular torsion is the sudden onset of unilateral scrotal pain of short duration, with subsequent spontaneous resolution.

(9) What can mimic testicular torsion?

What conditions may resemble testicular torsion?

Conditions that may mimic testicular torsion:

  1. Epididymitis,
  2. Hydrocele,
  3. Hernia,
  4. Schönlein-Henoch purpura,
  5. Trauma,
  6. Torsion of a testicular appendage,
  7. Varicocele

Diagnosis of testicular torsion:

(10) How is testicular torsion diagnosed? How to diagnose testicular torsion?
The doctor will examine the scrotum, testicles, abdomen, and groin. During a physical exam, your doctor will check your scrotum. He/she may also slightly rub or pinch the inside of your thigh which causes the testicles to contract. However, this reflex may not occur or disappear if you have testicular torsion.

Tests and methods used to diagnose testicular torsion:

  • (1) Blood tests which look for infection
  • (2) Imaging of the scrotum
  • (3) Urine tests to check for infection
  • (4) Nuclear scan of the testicles - this involves injection of radioactive material into the blood to detect areas of decreased blood flow
  • (5) Physical exams of the testicles, abdomen, or groin
  • (6) Ultrasound of scrotum: To assess blood flow to the testicles. If blood flow is lower, then it can be a sign of testicular torsion
  • (7) Exploratory surgery may be carried to identify whether symptoms are caused by testicular torsion or some another condition.

(11) What are the risk factors linked to testicular torsion?

Risk Factors of Testicular Torsion:

  • Testicular torsion is most common between ages 12 and 18.
  • The condition can run in families. Family history of testicular torsion can cause this condition.
  • If you've had testicular pain that went away without treatment, it's likely to occur again.

(12) Can you explode your balls?
If a ball is knocked hard or just in the right angle it can pop.

(13) Why does left testicle hang lower? Why testicles hang outside the body?
Testicles hang outside the men’s body because they need to be cooler than the temperature inside the body, in order to make sperm. Usually, the left testicle hangs lower. The testicles hang in the scrotum by a structure known as spermatic cord.

(14) How prevent testicular cancer?

Prevention of testicular cancer:

Some men have testicles that can rotate in the scrotum is a trait inherited by some males. If you have this trait, the only way to prevent testicular torsion is surgery to attach both testicles to the inside of the scrotum.

(15) What treatments are available for testicular torsion?
Torsion of the testes is a medical emergency, so you should never ignore sharp testicular pain. Surgical repair, or orchiopexy, is usually required to treat testicular torsion.

(16) What’s involved in the recovery from testicular torsion surgery?

What precautions you must follow after testicular surgery?
As with any surgical procedure, you may have discomfort after surgery. Your doctor will prescribe the pain medications. Orchiopexy doesn’t typically require an overnight stay in the hospital.

Precautions After Testicular Torsion Surgery:

  1. You’ll stay in a recovery room for several hours prior to discharge. If your testicle needs to be removed, you’ll most likely stay in the hospital overnight.
  2. After surgery, you will have to avoid athletic or strenuous activities.
  3. Avoid heavy lifting or straining during bowel movements.
  4. Don’t remain completely sedentary.
  5. Make sure to get plenty of rest to allow your body to fully recover.
  6. Your doctor will ask you to refrain from sexual activity and stimulation, such as masturbation and intercourse.

(17) What do you mean by torsion of the appendix testis?

Torsion of the appendix testis:

At the top of the testis, a small piece of normal tissue is located which is known as appendix testis. It has not any function. If this tissue twists, it leads to same symptoms as testicular torsion, such as pain, swelling, and redness. This condition doesn’t require any surgery instead your doctor will recommend rest and pain medication after observing your condition.

(18) What is the treatment of testicular torsion?

Treatment of testicular torsion:

Manual detorsion is sometimes possible but rarely. Testicular torsion usually requires surgery for treatment. Testicle can usually be saved by treating within 4-6 hours. The doctor will untwist the spermatic cord to restore blood supply. It is normally conducted under general anesthesia. After surgery, the doctor will advise to avoid strenuous activity and sexual activity for several weeks.

During surgery, the doctor will:

  1. Make a cut in the scrotum
  2. Untwist the spermatic cord
  3. Stitch one or both testicles to the inside of the scrotum,
  4. Suture both testicles

(19) How serious is testicular torsion?

What happens if testicular torsion goes untreated?

Complications of Testicular torsion:

  1. Testicular torsion causes the flow of blood to stop, causing sudden, often severe pain, and swelling of testes.
  2. Blocked blood flow can cause permanent damage or death of the testicle.
  3. If the testicle is badly damaged, it has to be surgically removed.
  4. Prolonged testicular torsion can lead to the death of the testicle and surrounding tissues.
  5. Damage or loss of a testicle affects a man's ability to father children.
  6. Untreated testicular torsion can result in testicular atrophy, causing the testicle to shrink.

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