Testicular torsion is a urological emergency characterized by the twisting of the spermatic cord, leading to reduced blood flow to the testicle. This condition requires immediate medical attention to prevent potential testicular damage or loss. At SHIFAA PAN African Hospitals, our urology specialists are experienced in diagnosing and treating testicular torsion promptly to preserve testicular function and alleviate associated pain.

Understanding Testicular Torsion:

Causes and Mechanism:

Testicular torsion typically occurs due to the abnormal twisting of the spermatic cord, which suspends the testicle within the scrotum. This twisting action can cut off the blood supply to the testicle, resulting in ischemia (lack of oxygen and nutrients) and potential tissue damage.

Risk Factors:

• Age: Testicular torsion most commonly affects males between infancy and early adulthood, but it can occur at any age.
• Previous History: Individuals with a history of testicular torsion in one testicle are at higher risk of experiencing it in the opposite testicle.
• Anatomical Factors: Certain anatomical conditions like a high scrotal attachment of the testicle (bell clapper deformity) can predispose to torsion.

Symptoms and Diagnosis:

Symptoms of Testicular Torsion:

• Sudden and severe testicular pain, often without a preceding injury.
• Swelling, redness, and tenderness of the affected testicle and scrotum.
• Abdominal pain, nausea, and vomiting may also occur, especially in younger children.

Diagnostic Procedures:

• Physical Examination: Evaluation of symptoms, scrotal examination for tenderness, swelling, and changes in testicular position (high-riding testicle).
• Ultrasound Imaging: Doppler ultrasound to assess blood flow to the testicles and confirm torsion by visualizing twisted spermatic cord structures.

Treatment and Management:

Surgical Interventions:

• Emergency Surgery (Orchiopexy): The standard treatment for testicular torsion involves surgical detorsion and fixation of the testicle (orchiopexy) to prevent future torsion episodes.
• Timely surgery (within hours of symptom onset) is crucial to restore blood flow and prevent testicular damage or loss.

Post-Surgical Care:

• Pain management, scrotal support, and monitoring for complications such as infection or recurrence.
• Follow-up appointments to assess testicular function, healing, and overall recovery.

Post-Treatment Care and Follow-up:

Long-Term Monitoring:

• Regular follow-up visits with urologists to monitor testicular health, function, and potential complications.
• Education on self-examination techniques and awareness of symptoms for early detection of any recurrent torsion episodes.

 

What causes testicular torsion, and who is at risk?

Testicular torsion results from the abnormal twisting of the spermatic cord and can occur due to anatomical factors or previous history. Males of all ages are at risk, with peak incidence during infancy and early adulthood.

 

What are the typical symptoms of testicular torsion?

Symptoms include sudden and severe testicular pain, swelling, redness, abdominal pain, nausea, and vomiting in some cases.

 

How is testicular torsion diagnosed, and why is prompt treatment essential?

Diagnosis involves physical examination, ultrasound imaging, and assessment of blood flow to the testicles. Prompt surgical intervention is crucial to restore blood flow, prevent testicular damage, and preserve fertility.

 

What are the treatment options for testicular torsion?

Emergency surgery (orchiopexy) is the primary treatment, involving detorsion of the twisted cord and fixation of the testicle to prevent future torsion episodes.

 

Are there long-term complications after testicular torsion surgery?

While prompt treatment usually preserves testicular function, delayed intervention can lead to testicular damage or loss. Regular follow-ups help monitor for complications and ensure optimal recovery.

 

Can testicular torsion recur, and how can it be prevented?

Recurrence is possible, especially in individuals with predisposing anatomical factors. Prevention strategies include awareness of symptoms, prompt medical attention for sudden testicular pain, and consideration of preventive surgical options in some cases.

 

What should individuals do if they suspect testicular torsion?

Immediate medical evaluation is crucial. Individuals experiencing sudden and severe testicular pain should seek emergency medical care to prevent potential complications associated with delayed treatment.