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Testicular Torsion and Surgical Detorsion

Emergency surgical treatment for rotation of the testis around its own axis.

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 and Surgical Detorsion?

Testicular torsion is a urological emergency in which the spermatic cord rotates around its own axis cutting off the blood flow to the testis. The frequency is about 1/4000 males, most commonly seen between 12-18 years of age. Bell-clapper deformity (the tunica vaginalis fully surrounding the testis) is the anatomical predisposing factor.

If surgical intervention is performed within six hours, the testis-salvage rate is 90-100%; after 12 hours, this rate falls below 20%. The diagnosis is clinical; scrotal Doppler ultrasonography supports the diagnosis but in suspicious cases imaging should not delay surgery.

During surgical exploration, torsion is reduced (detorsion) and testicular viability is assessed. A viable testis is fixed to the scrotum (orchidopexy). A necrotic testis is removed (orchiectomy). The contralateral testis must also be fixed prophylactically.

Symptoms

Sudden onset of severe scrotal pain
Nausea and vomiting (accompanying the pain)
High-riding testis and transverse position
Loss of cremasteric reflex
Scrotal swelling and redness

Risk Factors

Loss of testis (with delayed intervention)
Risk of contralateral testicular torsion (bilateral bell-clapper)
Testicular atrophy (after late detorsion)
Infertility (after unilateral testicular loss)
Wound infection

When to See a Doctor?

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

  • In sudden onset severe testicular pain, IMMEDIATELY go to the EMERGENCY department
  • If scrotal pain is accompanied by nausea and vomiting
  • When a change in testicular position is noticed
  • In acute scrotum presentation in children and adolescents

Treatment Methods

01
Emergency surgical exploration and detorsion
02
Orchidopexy (fixation of viable testis to the scrotum)
03
Orchiectomy (in necrotic testis)
04
Contralateral prophylactic orchidopexy (mandatory)
05
Manual detorsion (external rotation, temporary measure before emergency surgery)

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.