Twisting of the testis within the scrotum, causing severe pain
Each testis is suspended in the scrotum on a spermatic cord. The spermatic duct (vas deferens) and the blood vessels that supply the testis are contained in the spermatic cord. If the spermatic cord becomes twisted, the flow of blood to the testis is restricted, causing severe pain in the scrotum.
Torsion of the testis usually affects only one of the two testes. It sometimes occurs after strenuous activity but may develop for no apparent reason, even during sleep. Torsion of the testis most commonly occurs during adolescence, but it can develop at any age. The condition is potentially serious; torsion may result in permanent damage to the testis if not treated immediately.
Symptoms of torsion of the testis usually appear suddenly. They may include:
Sudden pain in the scrotum that tends to increase in severity.
Pain in the groin and lower abdomen.
Redness and extreme tenderness of the scrotum on the affected side.
The severity of the pain can cause nausea and vomiting. If you develop any of these symptoms, you should seek medical advice urgently.
Your doctor may arrange for ultrasound scanning of the scrotum to exclude other disorders that cause similar symptoms, such as epididymo-orchitis. If you have torsion of the testis, an operation is carried out to untwist the spermatic cord. Both testes are then anchored in the scrotum with stitches to prevent a recurrence of the condition. If this operation is performed promptly, the testis is usually undamaged. However, if a testis is irreversibly damaged, it will be removed.
Occasionally, the spermatic cord will untwist spontaneously. If your symptoms disappear, you should still consult your doctor because they may recur.
The testis is usually undamaged if the spermatic cord is untwisted within about 6 hours. Removal of one testis does not normally affect fertility because the remaining one is able to produce sufficient sperm. A testis can be replaced by an artificial implant for cosmetic reasons.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.