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Testicular torsion occurs when the spermatic cord, which supplies blood to the testicle, becomes twisted. It is most common between the ages of 10 and 18. The cause of the ailment is the excessive length of the spermatic cord and excessive mobility of the testicle. Untreated testicular torsion leads to ischemia of the testicular parenchyma, necrosis and testicular atrophy.
What is the testicle torsion?
Torsion of the testicle stalk is a painful condition that consists of a twist of the spermatic cord that carries blood to the testicles. The cause of this disease is too long seminal cord length and excessive mobility of the testicle.
Testicular torsion usually occurs in boys from 10 to 18 years of age, but can also occur in young boys and older men.
The causes of the torsion of the testicle stalk
Normally the testicles move freely inside the scrotum because they are very solidly surrounded by the tissues that support them. The factor that triggers the torsion of the testicle stalk is most often a sudden movement or jump during sports, which leads to an injury to the groin. The period of rapid maturation and growth also contributes to the appearance of this ailment.
Another reason is the ambient temperature – the torsion of the testicle most often occurs in the winter. A man’s scrotum under a warm duvet or blanket is relaxed, and when it is then exposed to cool air, it may contract, due to a sudden change in temperature. Torsion most often occurs in one of the testicles – therefore the exception is bilateral torsion of the testicles.
Many men suffering from testicular torsion were born prone to this disease without even knowing it.
The connective tissue in the scrotum in men with testicular torsion is much weaker, therefore the testicles are free to move and the risk of torsion of the spermatic cord increases.
The torsion of the testicle stalk can attack at any time, even without much physical activity. However, it is the sports injuries that most often lead to the disease.
Torsion of the testicle stalk – symptoms
Characteristic for torsion of the testicle stem is rapid testicular pain that occurs without fever and redness, accompanied by enlargement of the contents of the scrotum and swelling. The symptoms come on suddenly and can be very bothersome. Swelling of the testicle may affect only one or all of the scrotum. The symptoms resemble an inflamed epididymis.
The above-mentioned ailments may additionally be accompanied by:
- nausea,
- vomiting,
- muscle defense,
- dizziness,
- blood in semen
- nodules located in the scrotum.
Diagnosis of testicular torsion
The correct diagnosis is made primarily on the basis of clinical symptoms, physical examination, ultrasound examination of the scrotum (allows for 100% diagnosis of testicular torsion) and urine. Doppler ultrasound is only performed on low-risk men to rule out disease. On the other hand, direct test of the testicle is advisable in the event of sudden and acute pain.
Torsion of the testicle stalk – treatment
Treatment of testicular torsion should be undertaken immediately as it is a life-threatening condition. Therefore, gentlemen should remember that testicular pain should not be underestimated! There are cases when the testicles twist off by themselves. However, it is important to go to a doctor who (sometimes) is able to unscrew the spermatic cord (manual unscrewing is effective in 26-80% of cases, based on other tests).
The therapy of testicular torsion usually consists in surgical exposure and unscrewing of the testicle and its subsequent fixation with sutures. The time that elapses from twisting the pedicle to providing help is extremely important. If the torsion is complete and the time exceeds 48 hours, the testicle may become necrotic. It is important to see a urologist immediately if you experience sudden testicular pain.
A quick response and intervention of a doctor allows you to maintain the current functions of the testicles, but some complications may occur, for example, problems with fertility due to a reduction in the number of sperm.
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