Testicular Torsion

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is testicular torsion?

Torsion of the testicle causes the spermatic cord in the testicle to twist and stop blood flow to the testicle. It causes pain, swelling, nausea, vomiting and lightheadedness. Testicular torsion is a true medical emergency. Testicular torsion is also known as testicular ischemia, testicular twisting, or torsion of the testis. The most common cause of testicular torsion is injury, but it may also arise without apparent cause. Testicular torsion is most common in boys and young adults.

Testicular torsion develops when the spermatic cord within a testicle becomes twisted around the blood vessels in the testicle and scrotum, thereby cutting off the blood supply and potentially causing irreversible damage. Testicular torsion is an emergency that requires immediate medical care.

The symptoms of testicular torsion occur rapidly, although the condition varies among individuals. Some boys and men will have swelling and pain, while others will also have light-headedness, nausea with or without vomiting, or blood in the semen. Regardless of the severity of symptoms, all cases pose a risk of permanent damage.

Fortunately, testicular torsion can generally be treated successfully if done so within six hours of symptom onset. Manual or surgical correction of the problem can be performed, usually without further complications if rapid treatment has been obtained.

Testicular torsion is a serious condition. Seek immediate medical care or (call 911) for symptoms such as persistent vomiting; rapid, severe pain in one testicle; or swelling of one side of the scrotum.

Seek prompt medical care if you have brief recurrent episodes of testicular discomfort or persistent, mild pain in the testicle.

What are the symptoms of testicular torsion?

Testicular torsion causes an absence of blood flow within the scrotum and may result in a number of symptoms. The symptoms can vary in intensity among individuals.

Common symptoms of testicular torsion

Symptoms of testicular torsion can be severe and may include:

  • Abnormal position of a testicle

  • Brief episodes of pain followed by relief, which could be signs of incomplete torsion or torsion that recurs and resolves on its own

  • Feeling lightheaded

  • Groin or pelvic pain

  • Nausea with or without vomiting

  • Rapid, severe pain in one testicle

  • Swelling on one side of the scrotum

Symptoms that might indicate a serious condition

In all cases, testicular torsion is a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care or (call 911) if you, or someone you are with, have these serious symptoms:

  • Persistent vomiting
  • Rapid, severe pain in one testicle
  • Sudden swelling of one side of the scrotum

What causes testicular torsion?

Testicular torsion develops when the spermatic cord within a testicle becomes twisted around the blood vessels in the testicle and scrotum, thereby cutting off the blood supply and potentially causing irreversible damage.

What are the risk factors for testicular torsion?

A number of factors increase the risk of developing testicular torsion. Not all boys and men with risk factors will get testicular torsion. Risk factors for testicular torsion include:

  • Age (most common in males 10 to 25 years of age)

  • Family history (possible inherited basis for having insufficient connective tissue to support the testicle, a condition most common in infants)

  • Injury or trauma

  • Paraplegia

  • Previous episode of testicular torsion

  • Strenuous physical activity

  • Winter season

Reducing your risk of testicular torsion

You may be able to lower your risk of testicular torsion by:

  • Being aware of your potential risk factors and family history

  • Wearing protective gear when engaging in high-risk activities (football, soccer, bike riding)

How is testicular torsion treated?

Treatment for testicular torsion begins with seeking immediate medical care from your health care provider or an emergency department. To determine if you have testicular torsion, your health care provider will ask you questions, examine your testicle, and possibly request an ultrasound examination to assess blood flow.

The goals of treatment for testicular torsion are to resolve the condition immediately, reduce inflammation, and relieve symptoms such as pain and swelling. Testicular torsion may occasionally be resolved with manual manipulation, but most commonly, surgery is performed. In infants, the adjacent testicle is commonly surgically secured to prevent occurrence on the unaffected side.

What are the potential complications of testicular torsion?

Complications of untreated testicular torsion can be serious. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of testicular torsion can include:

  • Adverse effects of treatment
  • Atrophy of the affected testicle
  • Infertility
  • Orchitis (testicular inflammation)
  • Repeat episodes of torsion
  • Testicle removal
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 18
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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