Testicular Torsion (Twisting Of Testicle)
Description
Twisting of the testicles in the scrotum. The testicles are suspended from the spermatic cords, and these cords supply the nerves and blood vessels to the testicles. Normally the testicles are attached to the sides of the scrotum preventing twisting. At times these attachments are not present allowing the testicle to twist in the scrotum causing the vessels in the spermatic cord to become blocked. If the twisting is not relieved the testicle can die. It is most common in adolescents (12 to 20 years), but can affect all ages.
Symptoms
Sudden onset of severe pain in one testicle, occasionally one or previous episodes have occurred, unilateral scrotal swelling, nausea or vomiting, scrotal tenderness.
Tests
A history and physical exam will be performed. The diagnosis is confirmed by ultrasound or a radionucleotide scan of the testicle. In general the radionucleotide scan takes longer to perform and has been replaced by the ultrasound as the procedure of choice.
- CBC
- Chem 12
- Ultrasound
Treatment
Surgery is required and should be performed as soon as possible. Usually if the testicle is untwisted within 6 hours it can be saved. Many times the unaffected testicle will be attached to the scrotum to prevent future torsion of the healthy testicle.
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