What Is It?
Torsion of the testicle is an uncommon but serious condition in which the testicle twists on the cord that provides its blood supply. The twisting of this cord cuts off the blood supply to the testicle. It is extremely painful and must be treated immediately to prevent permanent damage to the testicle. Testicular torsion can happen after strenuous exercise or an injury, but it also can occur without any apparent cause. The condition can occur at any age but is most common between the ages of 10 and 20.
Sudden onset of severe pain and extreme tenderness in one testicle, with or without an obvious cause, is the most striking symptom. Other symptoms include nausea and vomiting associated with the pain, and swelling on one side of the scrotum.
The diagnosis is based largely on the symptoms described above and a physical examination. The testicle may be raised high in the scrotum on the affected side. Your doctor will try to make sure the symptoms aren't caused by other conditions that affect the testicle and scrotum, including epididymitis (inflammation of the cord-like seminal duct, located behind the testicle) and orchitis (inflammation of the testicle itself, often caused by infection). Under certain circumstances, a testicular cancer or tumor can present with symptoms similar to a testicular torsion. This occurs because there may be some bleeding into a testis cancer which can cause the same type of pain and swelling as a torsion of the testis. An ultrasound test to examine the contents of the scrotum may help sort out the cause. Some institutions will also perform a testicular scan which can sometimes be helpful in distinguishing one cause from another. Sometimes, surgery is necessary to make a definite diagnosis. It's important for the condition to be diagnosed rapidly to ensure the best outcome.