Testicular torsion: A testicle twist can land you in soup!

What is testicular torsion?

When the spermatic cord gets twisted by rotation of testicle, it leads to testicular torsion. The blood supply is cut off which leads to swelling and pain of severe nature.  Testicular torsion requires emergency medical attention. Although testicular torsion can occur at any age, it’s more common for ages 12-16.

Testicular torsion, knee pain

Causes and risk factors


Testicular torsion is usually caused by defective connective tissue in the scrotum in some men. Testicular torsion can result from an injury or vigorous physical activity. Occasionally, no causes are attributable for its occurrence.

The rotation of the testicle twists the spermatic cord. The spermatic cord supplies blood from the abdomen to the testicle. Too many rotations can cut off the entire blood supply and rapidly damage the testicle.

Symptoms and signs

Often young boys who experience testicular torsion will wake up with severe pain in the scrotum during the night or in the morning.

Symptoms and signs of testicular torsion can be:

  • Severe scrotal pain of sudden nature
  • Abdominal pain
  • Vomiting and nausea
  • Scrotal swelling
  • Pain during urination


A physician will diagnose testicular torsion by conducting a physical examination of the groin, abdomen, testicles and the scrotum.  Swelling and tenderness might be detected in the testicle. The other tests may include:

  • Doppler ultrasound: To check the blood supply. When complete testicular torsion occurs, blood flow will not occur.
  • Urine test: To test for any signs of infection.
  • Surgery: To rule out other conditions and establish testicular torsion, surgery could be performed.

urine test

Often, surgery is done if the pain lasts for hours and testicular torsion is suspected, as time is a crucial factor for saving the testicle.

Treatment and prevention


Surgery is often required for resolving testicular torsion.  On noticing the symptoms of testicular torsion, surgery should be the immediate recourse. Surgery for unaffected testicle is also performed to avoid a future risk of testicular torsion in the same.

Sometimes, the doctor may do a manual detorsion (untwisting of the testicle) followed by surgery to prevent its reoccurrence. Timely medical intervention (within 6 hrs) can save the testicle. Severely damaged testicle needs to be removed surgically.


Take measures to prevent injuries to your scrotum. Often incidences of testicular torsion are not preventable.

Individuals with a genetic trait for testicles rotation in the scrotum must surgically get their testicles attached to the scrotum.

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Following complications can result from testicular torsion:

  • Shrinkage or testicle damage: The testicle can get damaged or lead to permanent damage of the testicle from testicular torsion. Severely damaged testicles are removed surgically.
  • Infertility: Inability to father children.
  • Infection of the scrotum and testicle can result from testicular torsion.

Next Steps

Medical attention must be sought even if experiencing temporary episodes of pain in the testicle.

Red Flags

Seek immediate emergency medical help for any unpredicted and extreme pain the testicles.

Consult a top General Physician

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  • Acute scrotum. American Urological Association. Accessed 12 Feb. 16. https://www.auanet.org/education/acute-scrotum.cfm
  • Testicular torsion: MedlinePlus Medical Encyclopedia. Accessed 12 Feb. 16. https://www.nlm.nih.gov/medlineplus/ency/article/000517.htm

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