Overview

Testicular torsion is a painful twisting of a boy’s testicles and spermatic cord. The spermatic cord is a set of nerves, ducts, and blood vessels the leads from the groin to the testicles. Torsion can happen to one or both testicles. Torsion causes blood to not flow to the testicles. This can damage them. Treatment needs to be done right away to prevent long-lasting (permanent) injury to the testicles.

Causes

Testicular torsion in young boys and teen boys occurs when the testicles are not completely attached in the scrotum. This lets the testicles move more freely and twist. Torsion may happen during physical activity.

Testicular torsion in a baby happens when the sac around the testicles doesn’t attach to the scrotum.

Risk Factors

It usually occurs in boys ages 10 and older. It can also happen when a baby is growing in the womb (uterus), or shortly after a baby is born. The condition is sometimes seen in fathers, sons, and brothers. This means it may be linked to a gene.

Symptoms

The severity of the symptoms depends on whether the testicle is partly or fully twisted. Symptoms can occur a bit differently in each child. The scrotum may be:

  • Painful. The pain is usually very severe.
  • Red
  • Swollen
  • Firm (in a baby)
  • Bruised (in a baby)
  • Closer to the groin

Your child may also have nausea and vomiting.

Testicular torsion is a surgical emergency. If you suspect that your son has testicular torsion, he should be taken to an emergency department right away for evaluation.

The symptoms of testicular torsion can seem like other health conditions. Make sure your child sees his or healthcare provider, or is seen in the emergency department, for a diagnosis.

Diagnosis

The healthcare provider will ask about your child’s symptoms and health history. He or she may also ask about your family’s health history. The provider will give your child a physical exam. Your child may also have tests, such as an ultrasound. This is a painless imaging test that uses sound waves to see the scrotum and testicles and check blood flow.

Treatment

Testicular torsion usually needs to be treated right away. The more severe the torsion, the more quickly treatment is needed. In some cases, the torsion may be untwisted by hand. But surgery is still needed to keep the testicle in place so torsion can’t occur again. To reduce the risk of long-term problems, surgery should be done within 6 hours of symptoms. Surgery can also help stop torsion from happening again.

Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all treatments.

Complications

If the condition is not treated quickly, it can lead to loss of the testicle.

When to Call a Healthcare Provider

Testicular torsion is a medical emergency. If you think that your son has testicular torsion, he should be taken to an emergency department right away for evaluation.

After surgery, call the healthcare provider if your child has:

  • Symptoms that don’t get better, or get worse
  • New symptoms

Key Points

  • Testicular torsion is a painful twisting of a boy’s testicles and spermatic cord. Torsion can happen to one or both testicles.
  • Torsion causes blood to not flow to the testicles. This can damage them. Treatment needs to be done right away to prevent long-lasting (permanent) injury to the testicles.
  • It usually occurs in boys ages 10 and older. It can also happen when a baby is growing in the uterus, or shortly after a baby is born. The condition is sometimes seen in fathers, sons, and brothers. This means it may be linked to a gene.
  • Symptoms can include a painful, red, and swollen scrotum, and nausea and vomiting.   
  • To reduce the risk of long-term problems, surgery is often done within 6 hours of symptoms.
  • If the condition is not treated quickly, it can lead to loss of the testicle.

Next Steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.