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Testicular Torsion

Last Updated August 2023 | This article was created by familydoctor.org editorial staff and reviewed by Robert "Chuck" Rich, Jr., MD, FAAFP

What is testicular torsion?

Testicular torsion happens when testicles rotate and the spermatic cord becomes twisted. The spermatic cord supports the testes in the scrotum. When the cord twists, the blood supply to the testicle is cut off. If it’s not treated quickly, the testicle can die and will have to be removed. Or it can become so damaged it won’t work properly anymore.

This condition can occur at any age. However, it’s most common in newborns, teenagers, and older men.

Symptoms of testicular torsion

  • Sudden, severe pain in the testicles or scrotum. This pain may occur after trauma to the testicle.
  • One testicle may seem swollen. It might look like it’s higher in the scrotum than the other testicle.
  • Nausea, vomiting, dizziness, or blood in the semen.

What causes testicular torsion?

Some males have changes in their anatomy that make them more prone to this condition. It can also happen after heavy exercise or after an injury causes swelling in the area. However, sometimes the cause isn’t known.

How is testicular torsion diagnosed?

Testicular torsion is an emergency. You or your child should see your doctor as soon as possible.  The doctor will do a physical exam and order tests such as a urine test or ultrasound scan of the scrotum. Be sure to tell your doctor when the pain started. Also explain how it feels.

Can testicular torsion be prevented or avoided?

In many cases, the cause is unknown and can’t be avoided. But always take steps to avoid injuring the scrotum.

Testicular torsion treatment

Most of the time, you or your child will need to have surgery right away. During the surgery, your doctor will untwist the spermatic cord. They may also secure the testicles, so they don’t become twisted in the future. This procedure is called an orchiopexy.

It’s best if your doctor treats the torsion within 6 hours after symptoms start. That time provides the best chance of saving the testicle. If you wait longer, the testicle may be permanently damaged and need to be removed.

Living with testicular torsion

If you or your child have pain in the scrotum, see your doctor right away. If you’ve had surgery, follow all post-surgery rules from your doctor.

Questions to ask your doctor

  • Is the swelling in my scrotum caused by testicular torsion?
  • Will I have to have surgery?
  • How long is the recovery time after surgery?
  • What can I do to make myself more comfortable after surgery?
  • Will I be able to have children?
  • Will my sex life be normal after surgery?
  • If I’ve had testicular torsion once, am I more likely to get it again?

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