Testicular Torsion – A Painful Medical Emergency
Perhaps the most common testicular problem is a twisted testicle. This condition usually occurs in childhood and adolescence, but it can occur in men of any age. Some men are predisposed to testicular torsion as a result of inadequate connective tissue within the scrotum itself, but testicular torsion can happen to anyone with testicles.
The term “torsion” actually refers to impaired blood flow. Impaired bruit flow occurs when a testicle twists on the spermatic cord, which carries the spermatic artery, cutting off its own blood supply.
Testicular torsion can actually occur spontaneously and for no apparent reason. Sometimes it even happens during sleep. Oddly enough, the cord can untwist on its own before it gets to the urologist or other health care provider. However, if it happened to you once, you are most likely at risk of this happening again and most urologists would probably recommend that surgery is needed to repair the testicle or both testicles.
In adult men, the condition of testicular torsion is often the result of trauma to the scrotum or strenuous physical exertion. For example: A softball, baseball or golf ball hits a man hard in the scrotum causing torsion. (I had a patient who was the victim of a hard blow to the muzzle from a softball.) Getting kneed or kicked in the testicles can also cause testicular torsion. The pain from the twisting is actually worse than the kick that the twisting causes, so I hope you know not to ignore this! (Oh! And I’m a woman). Nausea, vomiting, and dizziness are often present when there is no blood supply to the testicle or if the injury is sudden. Fainting may also occur.
Testicular torsion is considered a medical emergency and usually requires surgery within four to six hours if the testicle is to be saved. An ultrasound of the scrotum usually confirms this diagnosis by showing the absence of blood flowing to the testicle.
Sometimes a surgeon or urologist will sew the testicle back into place so the torsion won’t happen again. If the condition is quickly diagnosed and promptly corrected, the testicle can continue to function properly.
After six hours of torsion, the chances that the testicle will need to be removed increases. Sometimes, even with less than six hours of torsion, the testicle can lose its ability to function. (Remember, you only need one testicle to produce testosterone and father a child. Testosterone is also produced by the adrenal glands.)
How will you recognize this situation? As the testicle’s blood supply is reduced, it gradually turns red, then purple, and finally blue. That’s when the pain becomes unbearable, and medical help is essential!
When participating in any sport with a fast-moving object, guys should either wear a cup or avoid trauma to the scrotum (in other words, never play goalie, catcher, or shooter without a cup).
Remember, this condition is a surgical emergency, regardless of your age. If symptoms of testicular torsion occur, seek immediate medical attention. call 911 in the United States, if you are in too much pain to drive. Somehow get to the nearest ER.