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Testicular Torsion

What is testicular torsion?
Testicular torsion is a twisting of the testicles and the spermatic cord (the structure extending from the groin to the testes that contains nerves, ducts, and blood vessels). This twisting or torsion causes decreased blood flow to the testes, depriving them of oxygen and nutrients. This is a painful conditions which usually occurs in boys 10 years and older. It may also occur during fetal development or shortly after a baby is born.

What causes testicular torsion?
In pre-adolescent and adolescent boys, torsion is thought to occur because of abnormal or incomplete attachment of the testes within the scrotum. This allows the testes to be more movable and to twist on their blood supply.

Testicular torsion found in the fetus, occurs when the protective sac that surrounds the testicles within the scrotum does not attach to the scrotum internally.

The cause of testicular torsion is unknown. Heredity may play a role as some cases have been seen in fathers, sons, and brothers.

What are the symptoms of testicular torsion?
The symptoms of testicular torsion may involve one or both of the testes. The most common symptoms of testicular torsion:

Scrotal (involving the scrotum):

Pain
Swelling
Bruising (in newborns)
Firmness (in newborns)
Redness
High-lying testicles

Nausea and vomiting
Loss of cremasteric reflex (reflex involved in controlling testicular movement into the pelvic cavity, which is normally elicited by cold, touch, emotional excitement, or exercise)

However it is important to keep in mind that each child may experience symptoms differently.

The symptoms of a testicular torsion may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

How is testicular torsion diagnosed?
Testicular torsion is usually diagnosed with a physical examination and a complete medical history. It is very important to make a quick diagnosis because prolonged testicular torsion may cause irreversible damage to the testes. Diagnostic tests may include scrotal ultrasound examination of blood flow to the testicles.

Treatment for testicular torsion
The specific treatment for testicular torsion will be determined based on:

Child's age, overall health, and medical history
Extent and expected course of the condition
Child's tolerance for specific medications, procedures, or therapies
Parent's preference and opinion

Testicular torsion usually requires immediate intervention to untwist the spermatic cord and restore blood flow. If the testicle has been deprived of blood flow for too long it may not be able to recover and removal of that testicle may be necessary. Surgery can also help prevent torsion from re-occurring because the operation also involves firmly attaching both testes to the scrotal sac.

The physicians of Georgia Urology have expertise in evaluation and treatment of testicular torsion in newborns, boys, adolescents and adults. Call today to schedule an appointment in one of our convenient office locations.