Testicular Torsion: Be sure to know about the sudden, severe pain!

Imagine if you were at a loss, or even sleeping, and suddenly felt unbearable pain in your testicle? This is not something you can just ignore. This is a medical emergency. Today we are talking about this dangerous, but if you are aware, avoidable condition called Testicular Torsion. It is very important for a boy, a young man, and also for parents to be aware of this.

What is Testicular Torsion? Let's understand it simply.

Simply put, Testicular Torsion is a twisting of the testicle around the blood vessel that supplies it. Did you know that our testicles are attached to a tube called the spermatic cord? This tube contains blood vessels, nerves, and other things that supply the testicle with blood.

Now imagine that just as a water pipe is twisted so tightly that the water stops flowing, when this spermatic cord is twisted, the blood supply to the testicles completely stops. When the blood flow is cut off, the tissue in the testicles begins to die. This is a very painful condition that requires emergency treatment. If treatment is delayed, the testicles can become completely damaged and have to be surgically removed.

How serious is this situation? Why is time so valuable?

Testicular Torsion is considered a medical emergency. If you experience sudden, severe testicular pain, you should go to a hospital's Emergency Department (ETU) without delay.

Time is more valuable than gold in this case, because every minute you delay seeking treatment decreases the chances of saving your testicle.

The table below will help you understand the seriousness of this better.

What are the symptoms of testicular torsion?

The main and most obvious symptom is a sudden, severe, sharp testicular pain. This pain can occur at any time, whether you are lying down, walking, or sitting. Sometimes, this pain can spread to the abdomen.

Other symptoms are:

• Swelling and pain on one side of the scrotum.
• Feeling like a lump in the testicle.
• One testicle is located higher than the other.
• Change in skin color of the scrotum (red, purple, brown, or black).
• Nausea and vomiting.
• Stomach ache.
• Frequent need to urinate.
• Fever.

For some people, this pain may come on suddenly, disappear for a while, and then come back. We call this Intermittent Torsion. Even so, don't ignore it. Definitely see a doctor.

Why is this happening? What is the reason for this?

Testicular torsion often occurs in people with a congenital condition called "Bell Clapper Deformity."

Normally, our testicles are firmly attached to the inside of the scrotum. So they can't twist easily. But, the testicles of people with this (Bell Clapper Deformity) are not attached like that. They can swing freely back and forth, like the pendulum on a church bell. Because they hang freely like this, they are more likely to twist easily.

It usually affects young boys, especially between the ages of 12 and 18. Also, if someone in your family has had this condition before, you may be at risk of developing it too.

Important: Many people think that this happens when they exercise, jump, or run. This is a misconception. Testicular Torsion is not caused by any physical activity. However, it can happen randomly even when you are exercising.

What complications can occur if urgent treatment is not sought?

This condition, which is a time-consuming battle, can lead to two serious complications if not treated promptly.

1. Permanent damage to the testicle: As we discussed earlier, if blood flow is cut off for more than 6 hours, the tissue in the testicle will begin to die. This is called an infarct. A testicle that is damaged in this way cannot be restored. The surgeon will have to remove it.

2. Male Infertility: Even if the damaged testicle is removed, the ability to have children does not completely disappear because the other testicle is still functioning well. However, some studies have shown that sperm count may decrease after testicular torsion. This may have some impact on the ability to have children.

How does the doctor diagnose this? What is the treatment?

When you go to the Emergency Department (ETU), the doctor will ask about your symptoms and perform a physical examination. In most cases, the condition can be diagnosed based on the symptoms and examination alone.

If you need further confirmation, a scrotal ultrasound scan can be done to see if blood is flowing to the testicles. This can quickly determine if blood flow has stopped.

The treatment is surgery!

The only treatment for testicular torsion is emergency surgery, which we call (Orchiopexy) .

This surgery involves:

• The surgeon makes a small incision in the scrotum and repositions the twisted spermatic cord.
• When the twist is reversed in this way, blood flow to the testicles begins again.
• Then, to stop the twisting again, the doctor stitches the testicle back together and attaches it to the inner wall of the scrotum.
• Often, the healthy testicle on the other side is also surgically fixed in the same way to prevent it from twisting in the future.

How long does it take to recover after surgery?

There may be some pain and swelling in the first few days after surgery. This is normal. Use the painkillers your doctor prescribes as directed.

• After about a week, the pain will have subsided considerably, and you will be able to resume normal activities (school, office work).
• However, you should completely avoid heavy lifting, running, jumping sports, and strenuous exercise for at least 3-4 weeks.
• It is best to talk to your doctor and seek advice before resuming any activity.

When should you see a doctor?

Let's talk about this in two parts. One is the emergency, and the other is what to watch out for after the surgery.