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Testicular Torsion
Testicular torsion refers to a spontaneous twisting of the testicle on its spermatic cord causing a "pinching off" of the blood supply to the testicle resulting in sudden, SEVERE pain and SWELLING typifying this disease. Testicular torsion is most common in the ADOLESCENT male, but it can occasionally occur in older males (20-30'S). Torsion of the testicle can occur with no provocation, in your sleep, or after exertion. Common symptoms include abrupt onset of one-sided testicular pain, swelling, redness, and tenderness of the scrotum. Nausea and vomiting are seen in some cases. These symptoms are similar to those of epididimytis, and they are often difficult to differentiate in the younger male. However, pain of epididimytis is of slower onset than torsion of the testicle. Fever is present with epididimytis and is NOT usually present with torsion. Evaluation will include history and physical examination. IMMEDIATE consultation with a Urologist is necessary in all cases of suspected torsion. In questionable cases, a nuclear scan of the testicle may be performed. Confirmed cases may spontaneously "untangle" themselves with instant relief of symptoms. The Urologist may need to perform exploratory surgery in order to reduce the torsion and surgically secure the testicle so torsion does not recur. Failure to treat the acute torsion can result in LOSS of that testicle, due to its lack of blood supply.
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