Why testicular torsion is an emergency

Dr. Elijah Felix of the Accident and Emergency Ward at the National Hospital, Abuja says testicular torsion, in simple terms, means twisting of the testis. This is a painful condition caused by the twisting of the spermatic cord, which causes loss of blood flow to the testicle. Testicular tissue cannot survive without blood flow. Torsion […]

Dr. Elijah Felix of the Accident and Emergency Ward at the National Hospital, Abuja says testicular torsion, in simple terms, means twisting of the testis. This is a painful condition caused by the twisting of the spermatic cord, which causes loss of blood flow to the testicle. Testicular tissue cannot survive without blood flow. Torsion is the most common cause of testicle loss in adolescent males. It is more common in growing adolescents, between the ages of 12 – 25.
If testicular torsion is recognized and treated immediately, the prospects of retaining normal testicular function is good. However, a delay of as little as a couple of hours in treatment can result in serious complications, such as testicle strangulation, permanent damage of the testicle, the death of the testicle and surrounding tissues, infection, loss of testicle function and male infertility, medical experts say.
Testicular torsion is characterized by excruciating one-sided testicular pain, with sudden swelling. Since the cord structures twist (like the strings of a puppet), the testicle elevates as well. Patients may have nausea and vomiting. Patients may also have abdominal pain. There may be a history of previous testicular pain. Fever may also accompany the testicular pain.
Testicular torsion could be as result of trauma, Dr. Felix says. This could be as a result of an accident or the testicle being hit, but again it can occur on its own. Some medical experts say the cause of majority of the cases is the bell clapper deformity, an anatomic abnormality that is present in around 12% of males. This anatomical condition allows the spermatic cord to twist more easily, resulting in compromise of the blood supply to the testicle. This can occur spontaneously or may be associated with trauma. There is no way to detect this deformity. In about 40% of men who have this anatomical abnormality, it is present bilaterally.
On if the man can still be active after the surgery, Dr. Elijah Felix says this depends on how early the surgery is done. “If it is done within few minutes after it was detected, then the testis can be salvaged, otherwise the testis can be damaged. The surgery is called orchiopexy and what we do is to stabilise the testis in the scrotum so that it will not twist. And the way we do it is that we untwist it in the opposite direction and stabilise it. Afterwards, we go to the second testis and make sure that it is also stable. Because if the first one twists, there is a possibility of the second having the same problem.”
Testicular torsion, also called torsion of the testicle, is rare. It generally occurs in teenage boys, although it can occur at any time in life. Experts warn that care at home is inappropriate and will only result in the loss of the testicle.