Testicular torsion
This can be a medical emergency. Go to the emergency department immediately for sudden testicular pain.
The testis twists on its cord, cutting off its blood supply. Surgery within about six hours usually saves the testicle.
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Causes
- Twisting of the spermatic cord, often with a 'bell-clapper' anatomical variant
Risk factors
- Age 12–18
- Previous episodes
- Bell-clapper deformity
Symptoms
- Sudden severe testicular pain
- Swelling
- Nausea and vomiting
- High-riding testis
- Abdominal pain in boys
Diagnosis — tests and examinations
- Clinical diagnosis — surgery should not be delayed for scans
Treatment
Operations and procedures
- Emergency scrotal exploration, untwisting and fixation of both testes (orchidopexy)
- Orchidectomy if not viable
Possible complications
- Loss of the testis
- Reduced fertility
Prevention
- Fixation of both testes after an episode
Outlook
Salvage rate above 90% within 6 hours, falling sharply afterwards.
When to see a doctor
Go to the emergency department immediately for sudden testicular pain.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
Related conditions
Educational overview, not medical advice. Treatment varies by person and location. Consult a qualified health professional for diagnosis or care. Read our content and model notes and privacy information.