The scrotum is the sack of skin beneath the penis. Inside the scrotum are two testes (plural of testis), also called testicles. Each testicle is connected to the rest of the body by a blood vessel called the spermatic cord. Testicular torsion happens when a spermatic cord becomes twisted, cutting off the flow of blood to the attached testicle. Most cases of testicular torsion affect guys who have a condition called a bell clapper deformity. In most males, the testicles are attached to the scrotum, making it hard for them to twist. In males who have the bell clapper deformity, the testicles are unsecured and can move and twist in the scrotum. Testicular torsion can happen to boys and men of any age, but is most common in 12- to 18-year-olds. It can happen after strenuous exercise, while someone is sleeping, or after an injury to the scrotum. A lot of times, though, there is no apparent cause.
If you have a testicular torsion, chances are you'll know it.
- You'll feel a sudden, possibly severe pain in your scrotum and one of your testicles.
- The pain might increase and decrease but generally won't go away completely.
- Swelling, especially on one side of the scrotum
- Nausea and vomiting
- Belly pain
- One testicle appears to be higher than the other
If you have a sudden pain in your scrotum, call a doctor and get to a hospital or doctor's office as soon as you can. Don't eat or drink anything until you've seen a doctor and found out if you'll need surgery. Testicular torsion is an emergency: When it happens, a guy needs surgery — fast. Saving the testicle becomes more difficult the longer the spermatic cord stays twisted.
Sometimes, the spermatic cord can become twisted and then untwist itself without treatment. This is called torsion and detorsion, and it can make testicular torsion more likely to happen in the future. If your spermatic cord untwists and the pain goes away, it might be easy to ignore it, but you should call the doctor anyway. Ignoring pain for too long or simply hoping it goes away can result in severe damage to your testicle and might lead to your testicle being removed.
