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What Is Testicular Torsion? Is It Painful?

Dr. Agnes Joseph

A painful situation in which the testicle suddenly rotates and twists the sperm cord that brings blood flow to the testes.

Testicular torsion often happens to boys between the ages of 12 and 18, though it is also seen in older men. Torsion of the testes is a relatively unknown phenomenon with far-reaching consequences.

What is torsion of the testes?

It is a phenomenon in which the testicle suddenly rotates and twists the sperm cord that brings blood flow to the testes. The blood flow is abruptly reduced or stopped, and the area becomes extremely painful and swollen. 

When this happens, you must see a doctor at once to remove the twist in the testicle. If left unattended for too long, the testes will not receive blood for a long period of time and become irretrievably damaged. When this happens, the testicle(s) may have to be surgically removed.

What causes it? 

  • The most common cause is vigorous activity like exercise or rough sex.
  • Testicular torsion also occurs with injury to the groin or pelvis.
  • Sleeping in an unusual position, or flailing about during sleep, may also cause it.
  • As surprising as it sounds, you could have a genetic disposition towards testicular torsion. It is often an inherited trait, in that the testicle rotates several times freely inside the scrotum. This may not always result in torsion. However, if the rotation results in blood flow being completely blocked or curtailed, then it is known as torsion and it must be treated quickly to contain damage to the testicle.
  • Inherited torsion traits often affect both testicles. However, even if you have this inherited trait, you might never suffer testicular torsion. But you must be careful to avoid any activity that might cause it.

Most cases of severe testicle torsion result in permanent damage to the testicle(s) or the inability to bear children (since it may hamper sperm production).

How do you know if you have testicle torsion?

  • You experience sudden, debilitating pain in your scrotum
  • The scrotum swells rapidly, and the testicle(s) change position or move to another angle
  • You might experience waves of abdominal pain
  • You might experience frequent bouts of urination, along with vomiting and nausea
  • In some cases, the pain in the scrotum is accompanied by mild to moderate fever

Whatever the stage of the testicle torsion, seek your doctor’s help at once. You cannot treat it by yourself and popping painkillers can interfere with the subsequent treatment. 

In conclusion

Even if you have had episodes of testicle torsion that went away without medical intervention, you must seek your doctor’s help in effecting a permanent cure. Frequent bouts of reduced or blocked blood flow to the testes may cause irretrievable damage to the testes. Most doctors recommend surgery to sew the testicles to the inside of the scrotum to prevent movement.

The doctor will conduct urine tests, testicular ultrasound or pelvic MRI or a pelvic laparoscopy to determine if the pain and swelling are due to testicle torsion or something else.

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