Testicular torsion is a serious medical issue that can affect males at any age. In this condition, one or both testicles rotate inside the scrotum, causing the connected spermatic cord to get twisted. Testicular torsion symptoms include pain in the scrotum, swelling, and extreme discomfort. It is common between the ages of 12 and 18.
Testicular torsion requires emergency treatment; otherwise, it can lead to permanent damage to the testicle. Read more to know more about the signs of testicular torsion and ways to prevent and treat it.
How Does Testicular Torsion Happen?
Inside the scrotum, the two testicles are separately connected to the body through the spermatic cord, a bundle of nerves, ducts, and blood vessels. When this cord twists, blood flow is disrupted, leading to intense pain and swelling, a condition known as testicular torsion.
How serious is testicular torsion? It is very serious, requiring prompt medical help if the pain continues. It needs to be treated within 4-6 hours of the onset of the testicular pain, as the testicle can be permanently damaged due to a lack of blood supply.
Now that you know what is testicular torsion, learn about its symptoms in the next section.
Common Testicular Torsion Symptoms
Testicular torsion symptoms can strike at any time, whether you’re awake or sleeping, active or inactive. You can identify testicular torsion by recognising the following symptoms or taking immediate action:
1. Sharp Pain in One or Both Testicles
The testicular torsion pain level is very high. This is the hallmark sign that will cause you to feel sudden, intense pain without any clear cause of injury, so much that you may not be able to rest or do daily activities. The pain is generally in just one testicle, and it’s rare to get congestion in both testes.
2. Swelling and Tenderness
Next, you may experience swelling or tenderness in that area. From the appearance, the affected testicle may appear higher than the other one and seem odd to look at.
3. Nausea and Vomiting
Some may feel nauseous and get the urge to vomit due to the extreme pain and sudden distress.
4. Lower Abdominal Pain
The pain may radiate to the lower abdomen. This can make it easy to confuse with other conditions like appendicitis or a hernia.
What Causes Testicular Torsion?
While testicular torsion can happen to anyone, there are certain testicular torsion causes that increase risk:
- Bell-clapper Deformity: This is a congenital condition in which the testicle is not properly attached to the scrotum, increasing its chances of rotation inside the scrotum.
- Trauma or Injury: An injury to the groin during sports or physical activities, such as jogging, wrestling, or running, can also trigger this torsion.
- Cold Temperatures: As per an NCBI study, hyperactive cremasteric reflex (HCR) in cold weather can cause the testes to retract up into the groin. This can increase the risk of testicular torsion in the winter season compared to other seasons.
The TWIST Test for Testicular Torsion Severity
The TWIST score, or Testicular Workup for Ischemia and Suspected Torsion score, is a clinical tool to decide if you’ve had a torsion. This test reduces the need for unnecessary ultrasounds for testicular torsion diagnosis.
Here’s how to get the score:
| Clinical Feature | Points |
| Testicular swelling | 2 |
| Hard testicle | 2 |
| Absent cremasteric reflex | 1 |
| Nausea or vomiting | 1 |
| High-riding testicle | 1 |
Based on your score, here’s how to interpret it for the possibility of a torsion:
| Score Range | Risk Level | Interpretation | Recommended Action |
| 0–2 | Low Risk | 100% negative predictive value for torsion | No ultrasound or urological consultation is typically required |
| 3–4 | Intermediate Risk | Possibility of torsion | Ultrasound warranted |
| 5 or above | High Risk | 100% positive predictive value for torsion | No ultrasound needed; urgent urological consultation and surgery to untwist the testis |
Some people wonder, “Can testicular torsion fix itself?” The answer is no. When you’re diagnosed with this condition, immediate medical evaluation is the safest course of action.
Research shows that if treated within 6 hours of symptom onset, the testicle can be saved in over 90% of cases. A long delay of 12 hours or more increases the risk of losing the testicle by 50% and after 24 hours, it’s almost impossible.
Testicular Torsion Treatment
Once the diagnosis is done, the only option left to fix is surgery. The doctor gives general anesthesia and starts the procedure of testicular torsion surgery:
- The surgeon will make a small incision in the scrotum to reach the twisted cord.
- They will untwist the cord and attach the testicle to the inside of the scrotum using stitches.
- Similarly, the other testicle will also be attached to prevent future problems.
How to Prevent Testicular Torsion?
To prevent future risks, you can opt for earlier surgery to prevent the condition, especially if you have a bell-clapper deformity in one testicle. Wearing protective gear during sports or athletic activities can also help avoid trauma. If you feel any pain or discomfort in the groin area or in the testicles, it is recommended to get prompt treatment.
Read More: Vasectomy Operation Reversed: How the Procedure Works and What to Expect
To Sum Up
Although testicular torsion symptoms are not that common, it is crucial to be aware of them. Do not neglect any signs of these conditions, such as sudden, sharp testicular pain and swelling. Seeking immediate help can be beneficial in preserving fertility and preventing long-term health complications.
