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Torsion of the Testes

Torsion of the Testes

What is testicular torsion?

Men have two testicles that are contained inside a sac known as the scrotum, which support and protect the testicles. There is a cord-like structure, known as the spermatic cord, which contains the testicular artery that carries blood to the testes.

Torsion of the testes happens when this cord twists, cutting off most of the blood to the affected testicle, and as a result the tissues in the testicle may begin to die. This is a serious and extremely painful condition, which needs immediate medical attention.

According to studies conducted by the American Urological Association, it is most common in younger men, although older guys and infant boys may also be affected.

Many of the men who have testicular torsion may have actually been born with a high risk for the condition, although might never have been aware of it.

What are the causes of testicular torsion?

The scrotum sac containing the testicles is usually composed of tissue which is strong and supportive. As a rule the testicles are firmly enclosed, and cannot move freely in the scrotum. Men and boys who have suffered torsion, have been found to have weaker connective tissue in the scrotum, which offers far less support for the testicles which are then able to move around in the sac.

  • If you have this condition, sometimes known as a deformity, you have a greater risk of the spermatic cord becoming painfully twisted by the freely-moving testes.
  • Torsion can also occur after an injury to the groin, especially during sports and physical activity. For contact sports, there are specially designed cups to wear for protection from what might be a severe injury.
  • Some adolescents experience rapid growth during puberty which is not always synchronised with all parts of the body. This may also result in a twisting of the spermatic cord.

Testicular torsion can occur at any time, even when a man is sleeping, especially if he is a restless sleeper who often twists and turns. The condition usually only takes place in one testicle. Research has shown that it is very rare for torsion to occur in both testes simultaneously.

The symptoms of testicular torsion

Severe pain and swelling are the main symptoms of the condition. The pain is usually very sudden and very extreme, and located in the scrotal sac. The swelling may be on one side only, but sometimes the entire scrotum may be swollen.

Some men may also experience along with the pain:

  • Nausea and vomiting
  • Lumps in the scrotum
  • Blood in the semen fluid
  • Sometimes blood in the urine

If you experience these possible symptoms, get emergency treatment as soon as possible. Remember that if the blood supply is cut off for more than 6 hours, irreversible tissue damage can occur.

Treating testicular torsion

This condition is considered by the medical fraternity as a medical emergency, so any sharp pain in the testes must never be ignored. Some men may have what is termed “intermittent torsion” when the spermatic cord may twist and untwist, but always with pain. The condition may recur and cause problems, so even if the pain comes and goes, it needs a medical examination.

In rare cases, a doctor has been known to manually untwist the spermatic cord, but surgery is usually required to get the job done. It is a very minor operation, and is performed under a general anaesthetic. The doctor may also insert tiny stitches to keep the testicle in place in the sac so that it does not move again.

The long-term outlook is very positive, but if there is no treatment within 48 hours, 90% of those suffering with torsion, will have to undergo the surgical removal of the affected testicle.

Many doctors recommend that men practise self-examination of their testicles on a regular basis, and if you detect something which seems abnormal, make an appointment to see the doctor.

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