Testicular Torsion

• Testicular torsion, is a sudden twisting of the spermatic cord which contains the blood vessels of the testicle. This can lead to blood supply to the testicle being cut off.
• This condition can lead to permanent damage to the testicle if it is not treated urgently.

• Pain in the testicles – the pain is usually severe and occurs suddenly
• Sometimes the pain is felt over lower abdomen and mistaken as abdominal pain (tummy pain)
• Nausea or vomiting
• Swelling and redness over the testicle and the skin of the scrotum (the sac that contains the testis)

• Testicular torsion can occur at any age group, even before birth.
• Peak occurrence: At birth, and during puberty (mostly occur between 12 – 18 years)
• Many boys or men who develop testicular torsion may have an abnormal anatomy which allows the testicles to rotate more easily in the scrotum.

• Generally, children may experience sudden testicular pain and swelling. Some of the children may have previously experienced intermittent episodes of testicular pain.
• Testicular torsion is an EMERGENCY.
• If you / your child experience any sudden onset of pain in the testicle / scrotum, especially if it is accompanied by redness and swelling, you / your child should IMMEDIATELY seek medical attention at a hospital’s Emergency Department.
• The diagnosis is usually made upon examination by the doctors. An urgent ultrasound would be arranged if required
• If the diagnosis of testicular torsion is confirmed, an emergency surgery will be required at the soonest possible time to treat the condition. Any delay in seeking medical treatment may lead to permanent damage to the testicle.
  
• The emergency surgery will be performed under general anaesthesia, so please do not eat or drink while you are / your child is on your way to the emergency department.

The treatment for testicular torsion is surgery. The surgery is performed under general anaesthesia and you / your child would be asleep throughout the operation. A small cut will be made in the scrotum and the testicles would be checked and untwisted by the surgeon. The surgeon will then put stitches around the testicle to fix it in a normal position so it will not twist again in the future.

Children who have testicular torsion usually have an underlying abnormality that causes the testicles to rotate easily in the scrotum. This can occur to the other testicle as well. Therefore, the surgeon will place stitches in both the testicles to prevent any future twisting.

Thankfully, if this is caught early and treatment is given, the chances of a full recovery is very high.

It is important for parents to come to the Emergency Department to seek urgent treatment together with the child, as the parental consent is required if an emergency surgery needs to be carried out by the surgeons.

Please do not eat and drink when you are / your child is coming to the hospital to prepare for emergency surgery if required.

After the surgery, the patient will be observed in the hospital for 1-2 days. Antibiotics will be given to prevent infection. Adequate pain killers will also be provided to reduce the pain from the surgery. The patient can usually go home within 2 days.

The doctors and nurses will teach the parent and the patient to take care of the wound. The patient will have to be absent from school for at least a week and avoid exercise for at least 1 month after the surgery.

The patient will need to come for follow-up review in the clinic for the doctors to check on your wound and the testicle.