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Testicular Torsion

A urological emergency in which blood flow is cut off as a result of twisting of the testis around the spermatic cord, requiring immediate surgical intervention.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Testicular Torsion?

Testicular torsion is a condition in which the testis twists around the spermatic cord, strangulating its own vascular pedicle and cutting off blood flow. Ischemia, which begins within minutes, leads to irreversible testicular damage and atrophy if not treated.

It is most commonly seen during puberty (12-18 years) and in newborns. An anatomical variant called 'bell-clapper deformity' predisposes to torsion by allowing the testis to rotate freely within the scrotum.

Golden rule: 'sudden scrotal pain = torsion until proven otherwise'. Diagnosis should be made clinically without waiting for ultrasound, and the patient should be taken to the operating room immediately. With intervention in the first 6 hours, the rescue rate is over 90%.

Symptoms

Sudden-onset severe testicular or scrotal pain
Elevated (pulled up) appearance of the affected testis
Swelling, redness, and tenderness in the scrotum
Nausea and vomiting
Absence of cremasteric reflex
Pain is constant and does not decrease with movement (different from epididymitis)

Risk Factors

Bell-clapper anatomical variant
Puberty and under 25 years of age
Cold exposure or physical activity (may be triggering)
Spontaneous torsion during sleep
Family history of torsion

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Go IMMEDIATELY to the emergency room when sudden severe testicular pain begins
  • Pain with swelling and discoloration in the scrotum
  • Any sudden scrotal pain in a child or young man
  • Even if the pain has resolved (spontaneous detorsion): high risk of recurrence, elective pexy is necessary

Treatment Methods

01
Emergency surgical exploration: surgery without waiting for imaging in every suspected case
02
Detorsion + orchidopexy: untwisting the torsion and fixing the testis to the scrotal wall with sutures
03
Prophylactic orchidopexy of the contralateral testis: the opposite testis is also fixed in the same session
04
Orchiectomy: mandatory in testis that has lost viability after more than 24 hours of ischemia
05
Manual detorsion: emergency room intervention under analgesia, buys time for surgery
06
Intervention in first 6 hours →90% rescue; after 24 hours →below 10%

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.