What is Torsion?
• The testicles are suspended in the scrotum by an attachment called as spermatic cord
• The spermatic cord carries the blood vessels supplying the testes
• Twisting or torsion of this spermatic cord can cut off normal blood supply to the testicles
• It is the most significant condition affecting the testes

Causes
• It can occur at any age but more common in adolescents and in newborns
• There is no known cause for testicular torsion
• A boy can just wake up with severe pain
• It can occur after trauma to the scrotum or during any activity

Symptoms
• Newborn can present with
• A scrotal mass
• Discolored and firm scrotum
• Adolescents can present with
• Sudden severe pain in the scrotum
• Swelling of the scrotal sac
• The testicle in the swollen scrotum will be placed a little higher or pulled up
• Abdominal pain
• Nausea and vomiting

Diagnosis
• Any scrotal pain is a medical emergency and needs to be seen right away
• Your doctor upon examination can diagnose a torsion based on :
• A painful, swollen scrotum
• Raised testicle
• Absence of cremasteric reflex (reflex elicited by stroking the inner thigh close to the groin which will normally produce a twitch in the scrotum)
• Your doctor will immediately refer to a urologist who will obtain an ultrasound of the testes to check for absence of blood flow

Treatment
• Torsion of the testes can cut off blood supply and delay in seeking medical help can cause permanent damage leading to death of the testicular tissue
• Hence surgical detorsion (untwist the spermatic cord) needs to be performed within few hours (ideally 4 hours) of the torsion to save the testes
• While at surgery the unaffected testes is also fixed into place in the scrotum so as to prevent it from getting twisted later on
Loss of a testicle
• If the affected testes could not be salvaged then it will still not delay puberty or hinder fathering children when older as the other viable testes can take over to maintain normalcy

Team Ovum Hospitals