Testicular torsion : The worst thing that can happen to your testicles


  • Testicular torsion majorly occurs between the age of 12 to 18
  • Testicular torsion generally occurs a few hours after vigorous activity
  • If the surgery takes place between 4-6 hours of initial pain there is a 90% chance that the testicle can be saved

Your testicles are your golden eggs, and these golden eggs face constant fear of being affected, infected or impaired because of your carelessness.  There are 9 major conditions that can affect your testicles. While anything happening in that region is critical enough, the condition of testicular torsion can be the most painful and most unforgiving, factually it is dangerous than testicular cancer.

9 Major conditions include:-

  1. Epididymitis

a) Epididymitis is the infection or inflammation caused to the epididymis, an epididymis is a long tube that is located right along with the testicles. A major cause of epididymitis can be STDs (sexually transmitted diseases), trauma, or a side effect as a result of vasectomy.

b) The symptoms of epididymitis can be mild or severe pain, swelling of the scrotum, nausea, and vomiting, and fever.


a) A hydrocele is a condition in which fluids buildup around the testicles. Hydrocele can affect a testicle or both the testicles, the storage of fluid could cause swelling of scrotum and groin area.

b) A hydrocele is not typically painful or damaging, and it may not need treatment. However, in rare cases, the pouch can get very heavy and thus start hurting.


a) This is a simple case of enlarged and dilated vein, in short, it is caused by few non-proper functioning veins. Even though this condition is normally painless and harmless, in some individuals it can cause low sperm count, which can further lead to infertility.

b) Most of the Varicocele don’t need treatment, but some of them might need to be treated and corrected using surgery.


a) Hypogonadism is a condition that is a result of the testicles not producing enough of the testosterone hormone. A deficiency of testosterone in men can cause many sexual and non-sexual problems like erectile dysfunction, no appeal towards sexual pleasure, infertility, osteoporosis, reduced body and beard hair, constant fatigue, and depression.

b) However, this can easily be treated with testosterone replacement therapy.


a) Orchitis is a condition in which there is inflammation in either one or both the testicles, a major cause of orchitis is either viral or bacterial infection, mumps is the most common cause of orchitis.

b) STDs such as chlamydia and gonorrhea can both be a reason for orchitis, signs, and symptoms include pain in scrotum and groin, this condition could lead to infertility, but orchitis can easily be treated by medicines and home remedies. 


a) Spermatocele is also known as a spermatic cyst, it is a fluid-filled cyst on the spermatic tubes, small cyst normally does not cause pain, but as the cyst grows larger they might cause pain and swelling.

b) If the cyst grows too big and is being an inconvenience or it is just being painful, the surgery I always an option, although there is a heavy change that cysts can regrow after surgery.

7.Testicular pain

a) Testicular pain can be caused due to many scrotal conditions while the other contributors for testicular pain are kidney stones, infections, and hernia. If the pain is persistent then you should quickly visit a doctor as testicular pains are generally bodies call for help.

8.Testicular cancer

a) Testicular cancer starts in the testicle of a man, although this can happen at any age, 15-44 is the age group in which such cases are very commonly found. Testicular cancer can be identified by a painless lump in the testicles, dull ache in testicles, tenderness in male breast tissues

b) Is cancer with the highest survival rate, can be treated with surgery and chemotherapy, 98% of people survive and remain fertile

9.Testicular torsion

What is testicular torsion?

Our testicles are a part of very complicated design and engineering, thus with the involvement of so many veins, blood vessels, spermatic cord, etc. in a confined space (in ball sack), it is easily possible for something to go wrong, and the instance in which it goes horribly wrong is when you get testicular torsion. Testicular torsion basically occurs when the spermatic cord twists in the scrotum, cutting off the blood supply to the testicle and generating severe pain.

Symptoms of testicular torsion?

The common age for testicular torsion to occur is 12 to 18, but this condition can easily develop in anyone at any age, basic symptoms to diagnose testicular torsion are severe testicular pain, irregular positioning of a testicle, vomiting, etc. although newborns may not feel the pain, their testicles begin to discolor or the testicle may disappear from the original position.

Risk factors that can lead to testicular torsion?

Most of the people diagnosed have no prior health issue and in some cases, the patient may have faced testicular trauma or testicular tumor, these cases increase the risk of testicular torsion. Other factors may include Bell-clapper deformity, in this situation the testicles are not properly and tightly attached to the scrotum, which provides them with free space to turn around and bounce, this could easily result in the heavy movement of testicles and thus result in twisting of the spermatic cord.

Testicular torsion generally occurs a few hours after vigorous activity, after a slight injury to the testicles or in your sleep. Cold temperature or quick growth of the testicle during puberty might also play a role.

How to diagnose testicular torsion?

A medical professional can diagnose the testicular torsion by touching and feeling the scrotum, sometimes medical professionals also use pinch test (on your thigh) to understand how the body reacts, if the physical examination is inconclusive, the patient is taken to the radiology room, where ultrasound is used to identify and recognize the cause of this testicular pain.

Urologists are the professionals that operate on any conditions related to the testicles or reproductive organ is general. In case there is no urologist available, visit your nearest doctor or a general surgeon.

How to treat testicular torsion?

Unlike many diseases, even the first instance of testicular torsion cannot be treated using medicines or IV, only ways to treat testicular torsion is by manual de-torsion or surgical de-torsion, however manual de-torsions only work in few cases and could be very painful and might even require surgery to avoid such circumstances developing again. Manual de-torsion in those rare cases is also effective if done in the first 6 hours of feeling the pain.

How much time do you have before you have a dead testicle?

The time could vary depending on the degree of twist to the spermatic cord, as per the general medical observation if the surgery takes place between 4-6 hours of initial pain there is 90% chance that the testicle can be saved, after 12 hours of initial pain the chances drop to 50%, after 24 hours the possibility to save a testicle is nearly 0%.

What should you do?

In case of severe pain or doubt regarding swelling in scrotum rush to the hospital near you, ignoring the pain for too long or thinking the pain would soon go away and everything would be fine, or trying to untwist your testicles can result in severe damage to your testicles, and might lead to your testicle being removed.

What happens if you ignore testicular torsion and continue with your life?

Although we are used to treating fever, flu, etc. this way, the pain of testicular torsion is too much to continue with your daily work, and even if you manage to survive through the day, and due to disruption in the blood supply, a condition called Gangrene will develop in your testicles and then avoid the spread of Gangrene and infecting other parts the testicle is removed by a surgical process.

Complications that may arise?

  • Damage to or death of the testicle: – If the patient does not approach a surgeon in a particular period, it may result in damage of the testicle
  • Inability to father children: – In rare cases, the damage causes the loss in ability to father children, which means there is a huge drop in fertility.

How can you prevent testicular torsion?

Having testicles that can freely rotate in the scrotum is a hereditary attribute in some males. If you have this attribute, the only way you can prevent testicular torsion is by surgery to attach both testicles to the inside of the scrotum.

Intermittent testicular torsion

This is the type of testicular torsion that is comparatively less risker and in this particular type, the spermatic cord twists to a particular angle or degree and then untwist itself, this could result in chronic testicular pain, nausea and vomiting, etc. this condition also comes with an underlining risk that any twist could turn into a proper testicular torsion and could possibly lead to orchiectomy (Surgical removal of the testicle).

However, people suffering from intermittent testicular torsion can opt for elective orchiopexy, and medically 96% of people who opted in for orchiopexy have experienced complete relief from their symptoms.

Surgery for testicular torsion

Testicular surgery is an emergency surgery procedure, this surgery generally lasts anywhere from 30 minutes to 60 minutes. Many torsion surgeries are outpatient surgeries and thus do not involve general anesthesia, instead, local anesthesia is injected in the spine, which numbs and disables the functions of body parts below your waist. Then with cuts of the scrotum the testicular bag is released out of the scrotum, then the bags are rotated in the opposite direction to remove the torsion.

Then the scrotum is stitched and the testicles are attached to the inside parts of the scrotum to avoid any further risk of torsion to take place.

Precautions after surgery

Guys need to give up all strenuous activities like sports, trekking, sex and sexual stimulation (masturbation) for weeks after the testicular torsion surgery, as testicles are a delicate part of the male body, it takes time for them to heal and if proper care is not taken during the healing period it could affect the testicles in a bad way. So it is important for guys to talk to the doctor and understand the healing process and by when can they return to regular activity.

If you had a testicle removed during the surgery, you can get prosthetic testicle fitted in through cosmetic surgery if you are conscious of the physical appearance, or there is nothing to worry about, removal of the testicle is not the end of the world, nobody except you, your family and doctor needs to know this, and it wouldn’t affect your fertility as even with one testicle you can still father a child.

Why is testicular torsion the worst thing that can happen to our testicles?

People are very afraid of cancer, people are extra cautious when it comes to cancer and are very aware of it. However, in terms of testicular cancer, there are 4 stages until it becomes fatal and 2 stages until which you lose your testicles.

However, when it comes to testicular torsion, people are not aware of it. It can happen to anyone and it is generally very common in teenagers, who are many time ruthless and careless about their bodies, testicular torsion also provides very little room for tolerance, as it just provides 6 hours for a decent chance of retaining both the testicles and the later it gets the lesser are the chances of that testicle to survive, thus it gives us 6 hours to save our testicle or else it’s chop-chop, thus it’s safe to assume, testicular torsion is the worst thing that can happen to our testicles.

Reoccurrence of testicular torsion    

Although it is very rare, testicular torsion can reoccur even after the fixation surgery, thus the parents should be warned of this situation, and educated that in case of such occurrence, they should immediately contact a doctor or/and visit a surgeon nearby.