Testicular torsion is an urgent urologic condition

Testicular torsion is a rare but urgent urologic condition that requires immediate medical care within four to six hours after symptoms begin. It happens when a man’s testicle twists or rotates within the scrotum, which also twists the spermatic cord that supplies blood to the scrotum. Without that critical blood supply, the testicle could become permanently damaged. If that happens, our Houston urologists have to remove the testicle.

How does this condition occur?

Physicians aren’t certain what causes torsion, but there are certain situations during which the condition occurs.

• Men who have a “bell clapper” deformity. Instead of having testicles that attach to the scrotum’s inner walls, their testicles hang and move within the scrotum. This may lead to testicular rotation.
• Torsion can also occur after an injury that involves the scrotum or testes.

There are also a few characteristics that raise a man’s risk of developing this rare, urgent urologic condition. For example, a man may be more likely to be affected if he is younger, has had testicular torsion before, or has a family history of the condition. The condition is more common in teens, whose parents should contact their pediatrician or head to the emergency room immediately if they experience symptoms.

What happens when a male’s testicle gets rotated or twisted?

The first and most common sign that one – or rarely, both – testicles are twisted is severe pain
that occurs suddenly. Here are the other warning signs.

• Visible lump on the testicle
• One side of the scrotum is painful and swollen
• Scrotal discoloration: may be red, brown, purple or black
• Abdominal pain
• Vomiting and/or nausea
• Urinating more than usual
• Fever

If a man notices sudden, severe pain, whether accompanied by one or more of the symptoms above or not, it’s time to get emergency medical treatment.

How do urologists diagnose and treat testicular twisting?

Our Houston urologists perform a physical examination and may order an ultrasound of the scrotum. This tells the physician whether there is blood flow going from the spermatic cord into the testicles. If the diagnosis is testicular torsion, our surgeons perform an orchiopexy to untwist the testicle and restore blood flow. They also stitch the testicles to the inner walls of the scrotum to prevent a recurrence of the problem.

After surgery, most patients have pain, bruises and swelling for about a week. Patients must restrict their activities during the first week and avoid strenuous activity or heavy lifting for about three or four weeks after surgery.

Our Houston urologists want to educate patients about this urgent medical condition

Testicular torsion is not a common problem, but quick treatment is critical. Our physicians want to inform men about this condition, so they can seek care as soon as possible. Men who are treated in the ER for this condition are encouraged to schedule a follow-up appointment at our office to manage their risk for a future recurrence. Contact us for an appointment.