What is testicular torsion?

Testicular torsion happens when a testicle rotates and twists the spermatic cord, which carries blood to the testicle. 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, redness, tenderness or hardening 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
• one testicle looks larger than the other
• difficulty walking
• tenderness if the area is touched
• discolouration of the scrotum

In babies and boys under 8, testicular torsion can be painless or cause only abdominal pain.

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

How is testicular torsion diagnosed?

To diagnose testicular torsion, your doctor will need to examine the area around the 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 will not work.

Other tests may include an ultrasound, x-ray, MRI or urine tests.

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. 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.

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.