Testicular torsion

5-minute read

If you think you or somebody else is experiencing testicular torsion, go to the nearest emergency department immediately.

Key facts

Testicular torsion is a condition that causes sudden, severe pain and swelling in the scrotum.
Testicular torsion needs emergency surgery to avoid a permanently damaged or dead testicle.
It is often associated with nausea, difficulty walking and a discoloured scrotum.
Testicular torsion is most common in teenagers and newborns but can occur at any age.

What is testicular torsion?

Testicular torsion happens when a testicle rotates, twisting the spermatic cord, where the main blood vessel carrying blood to the scrotum is located. The twisting (or torsion) blocks the flow of blood to the testicle.

Testicular torsion causes sudden pain and swelling in the scrotum or lower abdomen. This is an emergency situation – if left untreated, the condition can lead to a permanently damaged or dead testicle which must then be removed.

Testicular torsion is most common in teenage and newborn boys but can occur at any age.

When should I go to the emergency department?

If you think you or somebody else is experiencing testicular torsion, it is important to get to the nearest emergency department immediately. You can find the emergency department closest to you by using the healthdirect service finder tool below.

FIND A HEALTH SERVICE — Our Service Finder can help you find doctors, pharmacies, hospitals and other health services.

What are the symptoms of testicular torsion?

Signs and symptoms of testicular torsion include:

sudden, severe pain in the scrotum
swelling of the scrotum
nausea and vomiting
abdominal pain on the same side as the torsion
the testicle being in a strange position, such as higher than normal or on an unusual angle
difficulty walking
tenderness if the area is touched
discolouration of the scrotum

In younger boys and babies, the extreme pain associated with testicular torsion can cause them to wake in the middle of the night or early in the morning.

Sometimes, testicular torsion can cause a sudden pain in the testicle that goes away without treatment. This is because the testicle twists and then untwists on its own. If this happens, see a doctor as soon as possible. You might be advised that surgery is needed to prevent it happening again.

CHECK YOUR SYMPTOMS — Use our sexual health and lower body Symptom Checker and find out if you need to seek medical help.

What causes testicular torsion?

It is not always clear why testicular torsion happens. Most boys and men who get it have inherited a trait where their testicle moves freely inside their scrotum (known as bell clapper deformity). This might lead to testicular torsion. If the testicles grow especially fast during puberty, this is also thought to be a risk factor.

Testicular torsion happens most frequently:

within hours of intense activity
after a minor injury to the area
during sleep
in people who have had a previous brief episode of torsion that went away

Illustration of male anatomy, including normal state of testicle, bell clapper deformity, torsion of testicle and necrosis of testicle — An inherited trait, where a male's testicle moves freely inside the scrotum (known as 'bell clapper deformity'), might cause testicular torsion. If left untreated, the condition can lead to a permanently damaged or dead testicle which must then be removed.

How is testicular torsion diagnosed?

To diagnose testicular torsion, your doctor will need to examine the area around your scrotum. This might feel embarrassing and awkward, but it is very necessary.

The doctor will also check your cremasteric reflex, which is when the testicle automatically contracts when the inner thigh is stroked. The doctor will pinch your inner thigh on the painful side, but if there is testicular torsion the reflex won’t work.

How is testicular torsion treated?

Testicular torsion needs surgery as soon as possible. The longer treatment is delayed, the more likely it is there will be damage to the testicle.

To treat testicular torsion, the surgeon will make a small cut in the scrotum and untwist the spermatic cord, which carries blood to the testicle. They will then stitch one or both testicles to the inside of the scrotum, if they are moving freely, to prevent them from moving around and causing future problems.

Common questions

How do I know if my testicle is twisted?

Testicular torsion symptoms to look out for include sudden swelling and a severe pain in the scrotum, nausea and vomiting, abdominal pain, the testicle being in a strange position, difficulty walking, tenderness if the area is touched, and discolouration of the scrotum.

Will testicular torsion pain go away?

No – in most cases it requires immediate surgery. Go to your nearest emergency department if you experience the symptoms of testicular torsion.

Sometimes, testicular torsion causes a sudden pain in the testicle that goes away without treatment. This is because the testicle twists and then untwists on its own. If this happens, you should still see a doctor as soon as possible.

Resources and support

If you need to know more about testicular torsion, or to get advice on what to do next, call healthdirect on 1800 022 222 to speak with a registered nurse, 24 hours, 7 days a week (known as NURSE-ON-CALL in Victoria).