Summary about Disease
Testicular torsion is a painful condition that occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum. The reduced blood flow causes sudden and severe pain and swelling. Testicular torsion most often occurs in males between the ages of 12 and 18, but it can happen at any age, even before birth. It requires immediate medical attention to untwist the testicle, usually through surgery. If treated quickly, the testicle can usually be saved. However, when blood flow has been cut off for too long, the testicle might be damaged so severely that it needs to be removed.
Symptoms
Sudden, severe pain in the scrotum
Swelling in the scrotum
Abdominal pain
Nausea and vomiting
A testicle that is positioned higher than normal or at an unusual angle
Frequent urination
Dizziness
Blood in semen
Causes
Testicular torsion typically results from an inadequately supported testicle within the scrotum. This allows the testicle to rotate freely around the spermatic cord. Some possible causes or contributing factors include:
Inherited Trait: Some males inherit a predisposition to testicular torsion due to a congenital abnormality affecting the tunica vaginalis (the membrane covering the testicle).
Injury to the Groin: Although less common, a minor injury to the groin area can sometimes trigger testicular torsion.
Strenuous Exercise: In rare instances, vigorous physical activity might contribute to the condition.
Rapid Growth During Puberty: Hormonal changes and rapid testicular growth during puberty can increase the risk.
Cold Temperature: Can cause the cremaster muscle to contract suddenly, and this may result in testicular torsion.
Medicine Used
Testicular torsion is primarily treated surgically, not with medication. Pain management may involve:
Pain relievers: Before surgery, pain medication such as opioids (e.g., morphine) or NSAIDs (e.g., ibuprofen, ketorolac) may be administered to help manage the severe pain.
Is Communicable
No, testicular torsion is not a communicable disease. It is not caused by an infection or a pathogen and cannot be spread from person to person.
Precautions
There are no specific precautions that can guarantee prevention of testicular torsion, as the underlying cause is often an anatomical predisposition. However:
Awareness: Educate young males and their parents about the symptoms of testicular torsion so they seek prompt medical attention if pain or swelling occurs in the scrotum.
Prompt Medical Attention: If symptoms develop, seek immediate medical attention. Early diagnosis and treatment are crucial to saving the testicle.
How long does an outbreak last?
Testicular torsion is not an outbreak-related disease. It is an acute, individual medical emergency.
How is it diagnosed?
Diagnosis usually involves:
Physical Exam: A doctor will examine the scrotum, testicles, abdomen, and groin.
Medical History: The doctor will ask about the patient's symptoms and medical history.
Ultrasound: An ultrasound of the scrotum is the most common diagnostic test. It can assess blood flow to the testicles.
Urine Test: To rule out infection.
Surgery: In some cases, surgery is needed to confirm the diagnosis.
Timeline of Symptoms
The onset of symptoms is typically sudden and severe:
Initial Onset: Sudden, intense pain in the scrotum.
Within Hours: Swelling of the scrotum develops. Nausea and vomiting may start.
Progression: Pain intensifies as time passes. Testicle becomes more tender. If left untreated for more than 4-6 hours, the chances of saving the testicle decrease significantly.
If Untreated: Tissue death (necrosis) can occur within hours, leading to permanent damage or loss of the testicle.
Important Considerations
Time is Critical: Testicular torsion is a medical emergency. The longer the spermatic cord is twisted, the more likely it is that the testicle will be damaged beyond repair.
Surgical Intervention: Surgery is usually required to untwist the spermatic cord and restore blood flow.
Orchiopexy: During surgery, the testicle is typically stitched (orchiopexy) to the scrotum to prevent future torsion. Often, the other testicle is also fixed in place as a preventative measure.
Fertility: While testicular torsion and subsequent orchiectomy (removal of testicle) can potentially affect fertility, many men can still father children with one healthy testicle. Consult with a fertility specialist for guidance.
Neonatal Torsion: Testicular torsion can also occur in newborns. Management is different in these cases. The likelihood of saving the testicle is low, but surgery to prevent torsion of the other testicle is standard.