Testicular Torsion and Priapism (prolonged erection) are two male urology malfunctions where delaying treatment for longer than 4-6 hours can result in permanent urological damage. In this article, we’ll deal strictly with Testicular Torsion. Information on Priapism can be found on page 36 of my book, “Comprehensive Guide To Undertanding Testicular Pain….”.
What exactly is testicular torsion? Imagine a ball(testicle) hanging in a balloon(scrotum). The ball is normally stuck at the back to theinterior lining of the balloon. This stops the ball from rotating freely inside the balloon. But what happens when the ball is not stuck or stuck in the wrong place? This case describes what is called “Bell Clappers Syndrome” and the usual cause of testicular torsion. If we look at the real picture, two thirds of the testicle is enveloped by the tunica vaginalis, a pouch like membrane that attaches at the back of the testicle and prevents most movement of the testicle in the scrotum. In patients where attachment of the tunica vaginalis is too high up in the scrotum, the testicle is able to rotate on its spermatic cord. There are varying degrees of torsion with an incomplete torsion occurring where there is between 90 and 180 degrees torsion. A complete torsion occurs when the testicle has rotated more than 360 degrees.
The spermatic cord consists of arteries, veins, nerves, vas deferens, lymphatic vessels, pampiniform plexus and the tunica vaginalis. As you can imagine, if this cord gets twisted fresh blood supply is prevented, lymphatic fluid and blood starts to collect and the nerves start to send multiple electrical stimuli to the brain which registers as pain. If testicular torsion goes untreated for more than 6 hours, death to the testicle is aprobable outcome. Testicular torsion is extremely painful due to tissue swelling. It is highly unlikely, therefore, that a patient suffering from this problem would not seek immediate medical aid.
Recently a newborn was seen by a pediatrician at my hospital and she discovered that the baby had bilateral testicular torsion. This is very rare but can occur because frequently the testes have not yet descended into the scrotal sac, where they would normally have been attached to the tunica vaginalis. The movement of the testicle into the scrotum may predispose such a newborn to torsion especially if the testicle does not fuse to the scrotal wall adequately. This is often what is referred to as a congenital anomaly.
Other than having Bell Clappers Syndrome, injury to the genital area is the other usual cause for testicular torsion. The firststep in treatment for testicular torsion is the administration of morphine for pain. This is very quickly followed up with a visit by a urologist who will sometimes try to undo the torsion manually or send the patient to the operating room for a surgical detorsion. Surgical detorsion involves the sewing of the testicle to the posterior wall of the scrotum. Since 40% of men with testicular torsion show Bell Clappers in both testicles, the surgeon will also suture the other testicle to prevent future testicular torsion from occurring in the other testicle. Should the affected testicle be too decayed and the surgeon feels he is unable to save it, a procedure called an orchiectomy will be performed in which the testicle is removed. Down the road when the surgical area has healed, a artificial testicle may be inserted if the patient so desires.
In summary, I wish to stress that under no circumstances is testicular torsion a candidate for any kind of home remedy.
If you wish to learn more, please click on the link below to be taken to the secure ordering sight for my book, “Comprehensive Guide To Understanding Testicular Pain…” [wp_eStore_fancy1 id=4]
Dr Keats has practiced medicine for 37 years in Canada and the US. You can trust his expertise in handling cases of testicular torsion, twisted testicles, . We recommend you visit his website to learn more about testicular torsion, twisted testicles, .