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Testicular Torsion

Scrotum is the thin bag like tissue that is found behind the penis. There will be continuous blood flow into the scrotum normally. But when the testicle rotates suddenly it would twist the spermatic cord and stops the blood-flow into the scrotum. This condition is called testicular torsion and it commonly occurs on male children aged 12-17. Testicular torsion is a life threatening problem and needs to be operated immediately. Any delay in hospitalizing or proceeding with surgery can cause permanent damage to the scrotum resulting in removal of testicles.

Symptoms :

There will be severe or sharp pain in the scrotum bag. For some it will appear in the form of intense abdominal pain. The scrotum area will develop inflammation due to cut-off blood supply. In rare cases, there may be nausea and vomiting. The testicle will be elevated in position at unusual angle.

For some men the testicle twisting would release automatically (called detorsioning) without requiring any treatment or surgery.

If you see any of the above symptoms like swelling of scrotum bag or sharp pain in the testicles you should visit your doctor immediately.

Causes :

Exact cause for testicular torsion is not known.

The testicle rotates or twists around the spermatic cord which is responsible for bringing blood to the testicle. When it rotates several times, the blood flow can get blocked causing swelling of scrotum and testicles.

Some believe that testicular torsion is inherited by birth. Even small children can get this problem.

It may occur due to excess of physical activity, exposure to cold temperature for long time. Sudden injury to the scrotum area or blow can cause this problem. For some men it can occur while sleeping.

Who are at risk?

Adolescent men of age group 12-16 will often get testicular torsion. If you have family history of this problem, you have more chance. Even when the testicles have untwisted there is every chance for twisting it again.

It can lead to complications causing death to the testicle if the torsion is not treated for long time thereby blocking the blood supply.

Diagnoses :

Physical examination is enough to detect testicular torsion. He may look for the sharp pain on the scrotum region or swelling. He may order for scrotal ultrasound scan for checking the intensity of damage caused to the testicles.

Pictures of Testicular Torsion :

Images, Pics, Pictures and Photos of Testicular Torsion

Treatment :

The only treatment available for treating testicular torsion is surgery.

For some men, your doctor may try doing manual detorsion to untwist the testicle. However this may recur anytime.

The surgeon will make a small incision on the scrotum bag after giving general anesthesia. He would gently untwist the spermatic cord to regulate blood supply. He would further stitch either one of the testicles or both deep inside the scrotum to prevent further rotation.

It is necessary to get it operated within 6 hours of torsion if you want the testicles in healthy position. Any delay beyond that time does not guarantee for retaining the testicles.

Testicular torsion can occur in infants that have to be surgically operated for untwisting.

Once the testicles die inside (without blood supply for long time) it has to be removed by surgery. In that case, the men cannot have a child in future.

Testicular Torsion – Symptoms, Surgery, Pictures, Causes, Treatment

What is Testicular Torsion?

This is a condition which can develop when a testicle revolves on the spermatic cord. This is the cord that delivers the flow of blood to the testicles; so naturally, this revolution cuts off the flow of blood and swiftly causes severe pain as well as swelling. This problem is most frequently seen in males who are 10 years old to 25 years old, but it also may happen at any age.

Testicular torsion normally necessitates surgery which is considered emergency. If this condition is medically treated inside of a few hours, the testicle can normally be saved. But if waiting too long to get treatment this condition can create damage which is enduring and can as well affect the capacity to father any children. In fact when blood flow has been interrupted for much too long, the testicle involved may become so damaged that it will be necessary to be removed.

Testicular Torsion Symptoms

Symptoms and signs of testicular torsion consist of:

Abrupt and/or severe pain in one testicle

Tenderness in testicle

Enlargement of testicle

Swelling of the scrotum – which is the bag of skin under the penis which contains the testicles

Vomiting as well as nausea

Pain in the abdomen

Testicle which is positioned higher than standard or is at an odd angle

Sudden pain in the testicle which leaves without treatment – this occurs because the testicle twists and then on its own untwists – sporadic torsion and detorsion.

When a male experiences severe or sudden pain in the testicle, they need to seek emergency medical care immediately. While the symptoms and signs can be triggered by other conditions, if the problem is testicular torsion, treatment needs to be as quickly as possible in order to avoid severe harm or the loss of a testicle. If the twisted testicle goes away on its own the doctor still needs to be seen as surgery could be needed in order to prevent this condition from continuing to happen.

Additional symptoms which can be associated with this condition include:

Testicle lump

Blood in semen

Testicular Torsion Causes

Within the scrotum, the testicles are both secured at either end by the spermatic cord. Often, this cord can get twisted around one of the testicles which cuts off the supply of blood to that testicle. This can result in shrinkage or atrophy as well as tissue death or necrosis. The cause of most cases is known as the “bell clapper” deformity which is an anatomic abnormality that is seen in approximately 12% of males.

Many men may be susceptible to this condition because of inadequate connective tissue in the scrotum. But, the condition can also result from some trauma to the scrotum, especially if substantial swelling had occurred. It can also occur after exercise which is very strenuous or can happen for no obvious reason.

This problem is fairly common during infancy – usually the 1st year of life and at the beginning of adolescence – puberty. But it occurs most frequently in young males less than 25 years of age.

In boys and men who are at risk for this condition, the testicular torsion often happens with no apparent trigger. It can frequently start following:

An injury to the scrotum

Physical activity

Sleep

Risk factors can include:

Previous testicular torsion

Testicular Torsion Treatment

Medical professionals will ask the individual numerous questions to validate if the symptoms and signs are indeed caused by testicular torsion or some other condition. The physician will examine the scrotum, abdomen, testicles as well as the groin. The reflexes will also be tested by lightly rubbing or punching the inside of the thigh on the side which is affected. Usually this will cause the testicle to contract. If testicular torsion is not present, this reflex will usually not occur.

Doctors also often diagnose the condition with just a physical exam. But often medical tests are needed to confirm this diagnosis or to help to identify another reason for the symptoms. They include:
Blood/ Urine tests
Blood or urine tests, to determine whether the symptoms or signs are triggered by an infection

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Scrotal Ultrasound
Scrotal ultrasound, using sound waves which are high-frequency and generate images of the testicle as well as check for flow of blood.

Nuclear Scan
Nuclear scan of the testicles, which comprises the injection of small quantities of radioactive matter into the blood system. Using a special camera, it is possible to identify areas in the testicles which receives less blood, indicating torsion.

Surgery
Often surgery is needed to identify if the symptoms are indeed testicular torsion or other problems. If there is pain for a number of hours and the physical exam suggests testicular torsion, the individual may be taken directly to surgery without additional testing. Any further testing could cause delay of blood flow into the testicle and hinder any attempts to save that testicle.

In several cases, the physician might be able to untwist the testicle by pushing on the scrotum but the patient will still need surgery to prevent this from occurring again. Surgery for testicular torsion occurring at birth is not possible.

Surgery for this condition is normally done with general anesthesia, which means that the patient is not conscious. This surgery does not generally require a stay in the hospital. The physician will:

Make cut in scrotum

Untwist the spermatic cord

Stitch one or possibly both testicles to the inside of the scrotum in order to prevent rotation occurring again.

The quicker the testicle is untwisted, the greater the chance of a successful outcome.

Within 6 hours, the testicle can be saved in approximately 90% of the time. After 12 hours, the chances of saving the testicles fall to approximately 50%. After the 24 hour mark, the testicle can only be saved in about 10% of the time.

After surgery, strenuous activity including sexual activity will need to be avoided for several weeks.

Newborns and infants with testicular torsion

In some cases, surgery is needed to not only correct but also to diagnose this condition. This will stop future issues with any Infertility or male hormone production. The tough decision for the parents is deciding whether a newborn or infant should have surgery and the answer usually depends on the judgment of the baby’s doctor along with the wishes of the parents.

After birth
If a boy is born with symptoms or signs of testicular torsion, it can be too late for emergency surgery to help. In some cases, the physician may suggest a later, nonemergency surgery.

Before birth
If symptoms and signs of this condition occur after birth, the doctor may recommend emergency surgery.

Having testicles which can rotate or swing freely in the scrotum is an inherited trait that occurs in some males and does not in others. The only way to prevent testicular torsion in individuals who have this trait is with surgery to attach both testicles to the inside of the scrotum in order for them to not rotate freely.