Testicular Torsion

Testicular torsion occurs when a testicle twists on the spermatic cord, cutting off its own blood supply. It is a surgical emergency, most common in adolescent boys and young men, and prompt treatment is essential to save the testicle.

• Sudden, severe pain in one testicle or the scrotum
• Swelling and redness of the affected side of the scrotum
• The affected testicle may appear higher than normal or lie at an unusual angle
• Nausea and vomiting often accompany the pain
• Pain may also be felt in the lower abdomen

• Results from twisting of the spermatic cord, which supplies blood to the testicle, most often occurring spontaneously without a clear trigger.
• Can sometimes follow physical activity or minor trauma, though it often occurs during sleep or without any identifiable cause.
• Most common in adolescents and young men, though it can occur at any age, including in newborns.

• Diagnosed based on the sudden onset of severe testicular pain together with examination findings such as a high-riding, tender, swollen testicle.
• Doppler ultrasound, where available, can help confirm reduced or absent blood flow to the testicle, but should not delay urgent surgical referral if torsion is strongly suspected clinically, since time is critical for saving the testicle.

Testicular torsion is a surgical emergency requiring immediate referral, as the testicle can lose its blood supply and become non-viable within a matter of hours.

Emergency surgery to untwist the testicle and secure it in place (and often also the other testicle, to prevent future torsion on that side) is the definitive treatment and should be performed as soon as possible.

The chances of saving the testicle decrease significantly the longer treatment is delayed, so any suspected case should not wait for imaging confirmation before urgent surgical referral.

If the testicle has already lost its blood supply by the time of surgery, it may need to be removed.

• Seek immediate emergency care for sudden, severe testicular pain — this is not a symptom to wait out or manage at home.
• Educate adolescent boys and young men to seek urgent care for sudden testicular pain rather than feeling embarrassed to report it.
• There is no reliable way to prevent testicular torsion, since it usually occurs without a clear trigger, making rapid recognition and treatment the most important protective step.