What is testicular torsion?
Testicular torsion is a twisting of the testicles and the spermatic cord. This cord
is the structure extending from the groin to the testicles that contains nerves, ducts,
and blood vessels. The torsion causes decreased blood flow to the testicles. This
strangles them of oxygen and nutrients. It is a painful problem that usually occurs
in boys ages 10 and older. While it generally occurs in adolescent boys, it may also
happen during fetal development or shortly after a baby is born.
What causes testicular torsion?
In preadolescent and adolescent boys, torsion occurs primarily from incomplete attachment
of the testicles within the scrotum. This permits the testicles to be more movable,
allowing them to twist. Testicular torsion detected in the fetus happens when development
of the protective sac that surrounds the testicles within the scrotum does not attach
to the scrotum internally.
The condition is sometimes seen in fathers, sons, and brothers. So it may be genetic.
What are the symptoms of testicular torsion?
The symptoms of testicular torsion may involve one or both of the testicles.
It can cause the following symptoms in the scrotum:
Bruising in newborns
Firmness in newborns
It can also cause the following:
The symptoms of a testicular torsion may look like other medical problems. Always
talk with your child's healthcare provider for a diagnosis.
How is testicular torsion diagnosed?
Testicular torsion is usually diagnosed with a physical exam and a medical history.
Your child’s healthcare provider may also do an ultrasound. This is a noninvasive
test that uses sound waves to make pictures of the scrotum and testicles to check
blood flow. Some healthcare providers may also send children with typical symptoms
straight to the operating room for definitive treatment. It is important to make a
prompt diagnosis because prolonged testicular torsion may cause irreversible damage
to the testicles. Other diagnostic tests may be included. However, there is no test
that can diagnose testicular torsion accurately all of the time.
What is the treatment for testicular torsion?
Testicular torsion usually requires immediate intervention. The severity of the torsion
depends on if the testicle(s) is partially or completely twisted. The more twisted
the testicle, the more urgent the intervention. To minimize long-term problems, intervention
is usually required within 6 hours of symptoms.
Most boys who develop testicular torsion will require prompt surgery to correct it.
Surgery will help prevent torsion from occurring in the future. In some cases, manipulation
by hand to untwist the torsion may be possible.