Men’s Health
Testicular Torsion
Our pediatric and adult urology teams deliver complete care for testicular torsion. We also treat the injuries and congenital conditions (present from birth) that lead to this emergency condition.
Medically reviewed by Marc Dall'Era, M.D. on Aug. 23, 2023.
Care for Testicular Torsion
The male reproductive system includes two testicles (testes) that sit inside a pouch of skin called the scrotum. Your testicles produce sperm as well as testosterone and other hormones.
Testicular torsion is a medical emergency. It happens when a testicle twists inside your scrotum, cutting off its blood supply.
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What Is Testicular Torsion?
Your body supplies blood to your testicles via two spermatic cords (also called testicular cords). Your spermatic cords are long, thin tube-like structures. They run from your abdomen down to the inside of your scrotum to each testicle.
Normally, tissue connects your testicles to your scrotum. But if your testicles hang freely inside your scrotum, they can rotate. This rotation can twist your spermatic cord, making it impossible for blood to get through.
Without blood, your testicle will shrink and can eventually die. That’s why it’s so important to seek medical care to restore blood flow. Physicians can save most testicles when they treat testicular torsion within the first six hours.
Testicular torsion rarely happens to both testicles. It more commonly occurs on just one side — most often, the left.
Testicular Torsion Symptoms
If you experience sudden or intense testicular pain on one side, seek emergency care immediately. Treatment within six hours of your symptoms starting can prevent lasting damage to your testicle.
Emergency Symptoms
Other emergency signs of testicular torsion include:
- Blood in your semen (whitish fluid your penis ejaculates)
- Change in your scrotum’s skin color, including redness or bruising
- Lump on one testicle
- Nausea and vomiting
- Swelling in one testicle
- Testicle that is sitting higher than the other one (riding high)
Causes and Risk Factors of Testicular Torsion
When testicles are not connected to your scrotum, it can lead to testicular torsion. A congenital abnormality known as a bell clapper deformity is the most common cause of unattached testicles. Injuries or trauma to your testicles or scrotum can also cause testicular torsion.
You may be more likely to develop testicular torsion if you have these risk factors:
Age
Testicular torsion most often happens between the ages of 12 and 18. But newborns and older men can also develop testicular torsion.
Family History
You may be more at risk for testicular torsion if someone in your family has had it.
Personal Health History
You are more likely to develop testicular torsion if you have a bell clapper deformity or have had testicular torsion before.
Diagnosing Testicular Torsion
To diagnose testicular torsion, your health care provider will examine your testicles and scrotum. They may also use medical imaging techniques like ultrasound.
Ultrasound uses sound waves to create pictures of your testicles and surrounding organs. It shows how well blood is flowing to your testicles.
Testicular Torsion Treatment at UC Davis Health
Our urologists (urinary tract and male reproductive system specialists) fix testicular torsion with surgery (orchiopexy). While your emergency room provider may be able to untwist your testicle manually, you will still need surgery.
At UC Davis Health, our urologists have expertise in the full range of urinary tract and male reproductive surgeries, including orchiopexy.
Read more about pediatric urology and male urology at UC Davis Health.
Orchiopexy
During testicular torsion surgery, we untwist your testicle to restore blood flow. We then attach your affected testicle to your scrotum to prevent it from twisting again. If you have a bell clapper deformity, we may attach the other testicle as well. Orchiopexies are outpatient procedures, meaning they do not require a hospital stay.
Orchidectomy
If you delay getting treatment, your urologist may need to surgically remove your affected testicle (orchidectomy). Orchidectomies are usually outpatient procedures. If your other testicle is at risk of testicular torsion, we can connect it to your scrotum during this procedure.
Who does it affect?
1 in 4KMales younger than 25
Source: Urology Care Foundation: What is Testicular Torsion?
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