Testicular torsion is a medical emergency when a testicle twists around the spermatic cord, cutting off the blood supply. Most people experience severe pain in the scrotum and one testicle, but occasionally testicular torsion happens without causing pain.
The Society for Academic Emergency Medicine (SAEM) explains that testicular torsion can occur at any age but is most common in babies during their first year and when the child reaches puberty.
Although testicular torsion can be painless, it is still a medical emergency and needs immediate treatment.
This article explains the pain and symptoms of testicular torsion and how to tell if a baby is experiencing it.
Most people with testicular torsion experience intense pain in their scrotum and one of their testicles. The pain usually comes on suddenly and sometimes spreads to the abdomen.
The Urology Care Foundation (UCF) acknowledges that some people find their pain starts slowly, building up over hours or days. However, the UCF stresses that this is unusual.
The study writers advise doctors to use ultrasound to help them diagnose testicular torsion, as delaying surgery may mean the person loses that testicle.
According to the
- sudden, intense, and persistent pain on one side of the scrotum and one testicle
- nausea and vomiting
- lower abdominal pain
- swelling in the testicle, and it will feel larger than the other
- changes in the color of the scrotum, such as red or dark skin
People with testicular torsion are often distressed and in significant discomfort, and some people have difficulty walking.
The NCBI also notes that some people only feel pain intermittently and that sometimes the person only experiences lower abdomen and groin pain.
Babies can also get testicular torsion. According to the UCF, the symptoms are usually different.
Babies tend to have a hard mass in their scrotums, and the surrounding skin may be darker than usual.
Unlike older children and adults, infants with testicular torsion may not express any pain.
According to UCF, newborns can have testicular torsion, but it is very rare. UCF also notes that doctors are seldom able to save a newborn’s damaged testicle and usually have to amputate it.
Testicular torsion occurs when the spermatic cord that supplies blood to the testes twists, cutting off the blood supply.
Doctors call this a bell clapper deformity, and it usually affects both testicles.
The testicle shrinks and withers if it does not receive blood for 6 hours. Due to a lack of blood, the testicle could “infarct,” or die.
Testicular torsion is a medical emergency, so anyone experiencing symptoms needs immediate medical attention.
Doctors can usually save the person’s testicle if they perform surgery within
Many doctors can diagnose a person’s testicular torsion during a physical exam. They may gently feel the person’s scrotum to check if one testicle is higher than the other and whether there is any swelling.
All people with testicular torsion need surgery, according to the UCF. In addition, doctors need to act quickly to save the person’s testicle. If they can perform surgery within 6 hours of the person’s symptoms starting, there is a
Sometimes, doctors can untwist the spermatic cord manually during the physical exam. However, people will still need surgery to prevent it from recurring.
During surgery, doctors unravel the twisted spermatic cord and sew it in place. They may also add stitches to the other testicle if the person has a bell clapper deformity.
Doctors will remove the testicle if it is too badly damaged and they cannot save it.
Most people recover fully from surgery and can resume their usual activities within a few weeks.
The UCF adds that even if doctors remove the damaged testicle, the person’s other one usually produces enough sperm for them to be fertile.
However, it may be more difficult to treat testicular torsion in newborns. The UCF states that there have been cases of a second testicular torsion in newborns once surgeons have removed one testicle.
In these cases, surgeons may have to remove both testes. However, testicular torsion in newborns is very rare.
This section answers some frequently asked questions about testicular torsion.
Can people have testicular torsion without pain or swelling?
Most people experience swelling in the scrotum and testes, but this may not be immediately obvious.
Some people only feel pain intermittently, while others find it excruciating.
Would it be obvious if a person had testicular torsion?
The classic symptoms are obvious, and SAEM says many doctors recognize them immediately without further tests.
According to the UCF, any signs of swelling in the scrotum need prompt medical interventions to preserve the person’s testicle.
What can be mistaken for testicular torsion?
Although the symptoms of testicular torsion are fairly recognizable, the
- hydrocele, a buildup of fluid in the tissues surrounding each testicle
- epididymitis, where the tube that carries sperm — the epididymis — is inflamed and swollen
- orchitis, which is inflammation of the testicles
- traumatic hematoma, where broken blood vessels leak blood into the nearby tissue after an accident or injury
Testicular torsion is a medical emergency that happens when the cord supplying blood to a person’s testicles twists and cuts off the blood supply to the organ. People need surgery to correct this.
It is usually severely painful, and the person’s scrotum swells. However, some people can have it without feeling any pain, although they will still have swelling.
If doctors can perform surgery within 6 hours of the person’s symptoms starting, there is a 97% chance of the testicle being healthy.
After this brief window, the likelihood drops, and the chance of testicle recovery falls below 10% after 48 hours.