Testicular torsion is a condition wherein the spermatic cord that provides blood supply to the testicle is twisted, resulting in the blood supply to the testis being cut off. The condition is most common in young adolescent boys between the ages of 12 and 18. Very rarely it is seen after the age of 30. Among neonates, the condition may develop prenatally or postanatally and is one of the causes of congenital monarchism. Although some men may be genetically and/or anatomically pre-disposed to the condition, it may also result from trauma to the scrotum, temperature fluctuations, or after strenuous exercise. Torsion primarily occurs from an incomplete attachment of the testes within the scrotum. Males who notice either one or both of their testicles to be able to rotate freely within the scrotum are at higher risk of developing torsion. Symptoms of testicular torsion include sudden onset of severe pain in one testicle, scrotal swelling, nausea, giddiness, and occasionally, fever. Unlike epididymitis, elevation of the scrotum does not reduce the pain in the case of testicular torsion.
The most efficient way to diagnose testicular torsion is by a Doppler sonography of the scrotum to identify the presence or absence of blood flow to the testicle. It is important to diagnose the condition immediately after the onset of symptoms, since testicular viability may be compromised. If corrective action is not taken within six hours after the onset of the symptoms, the chance of testicular salvage is reduced drastically. A simple surgery, which involves untwisting of the spermatic cord and a permanent suturing of the testicle to the inner lining of the scrotum is all that is need as a corrective measure. In most cases, the non-affected testis is also sutured, to prevent any risk of a similar torsion in the future. In case the testicle is dead due to prolonged testicular torsion, it must be removed to prevent gangrenous infection.