Testicular torsion: the Signs to Look Out For

Testicular pain isn’t always linked to a torsion, however, when it’s intense, sudden or accompanied by swelling, you shouldn’t ‘wait to see what happens’. In this sort of situation, time is of the essence.

Testicular torsion occurs when the testicle twists round on itself, causing the spermatic cord to twist. As a result, blood flow to the testicle is reduced or cut off, causing sudden pain and requiring urgent medical attention.

It mainly affects teenagers and young men, but it can also occur at other ages, including, more rarely, in infants. It can occur for no obvious reason, whilst sleeping, after physical exertion or, occasionally, following an impact.

The most typical symptom is a sudden, intense pain on one side. This isn’t the only symptom, however. You may also experience:

• A swollen scrotum
  
• A testicle that’s situated higher than usual
  
• Nausea and vomiting
  
• Lower abdomen pain
  
• Reddening around the area
  
  

In other words, it’s important not to minimise the situation, especially if pain comes on quickly. Even if it goes away on its own, you should still seek medical advice promptly, as episodes of torsion followed by spontaneous retortion may occur, with a risk of recurrence.

This really is the key point: the sooner treatment is sought, the greater the chances of saving the testicle. Medical sources indicate that after around 6 hours of pain, the risk of severe damage increases significantly, and that after 12 hours, the risk of having to remove the testicle becomes much greater.

To put it another way: if in doubt, it is far better to seek medical advice even if it turns out to be nothing than to wait too long. The NHS’s advice to the general public is along the same lines and recommends seeking immediate medical attention in the event of sudden, severe testicular pain, especially if it is accompanied by nausea, vomiting or abdominal pain.

The doctor begins with a clinical examination. Depending on the situation, an ultrasound scan of the scrotum may be carried out to check blood flow. However, when there is strong suspicion of the condition, doctors may decide to proceed directly to the operating theatre without wasting time on further tests.

Treatment usually involves surgery. The aim is to return the testicle to its correct position and then secure it to prevent it from twisting again. In practice, both testicles are often secured, precisely to minimise the risk of recurrence.

Not all testicular pain is caused by torsion. It could also be due to an infection, inflammation, injury or some other problem. But at home, it’s not easy to tell the difference yourself, especially when the pain is sharp and sudden.

So the best course of action is not to try to diagnose the problem yourself. It is to seek medical advice as soon as possible.

If you get a sudden pain in your testicles

• Don’t wait for it to pass
  
• Don’t try and fix the problem with painkillers and rest
  
• Get urgent help
  
• Seek help straight away if the pain is severe or is accompanied by feeling unwell, vomiting or abdominal pain
  
  

A question that often comes up after testicular torsion is: will I still be able to have a normal sex life? In the vast majority of cases, provided treatment is prompt, the answer is yes.

After the operation, it is generally advisable to wait a few weeks before resuming sexual activity, to allow sufficient time for healing. Your surgeon will advise you on the most appropriate timeframe for your situation.

In the longer term, testicular torsion treated promptly does not usually prevent you from having sex, achieving erections or experiencing pleasure. However, if treatment was delayed and a testicle had to be removed, medical follow-up may be recommended to check that everything is functioning normally, particularly with regard to fertility if necessary.

Testicular torsion isn’t the most glamorous of topics, but it’s definitely a symptom you need to be aware of. Sudden pain in the testicle is never something to ignore, especially if it’s severe. The right thing to do is not to wait, but to act quickly.