Testicular Torsion

Testicular torsion is a sudden medical condition affecting the male reproductive system, specifically the testicles. It occurs when the spermatic cord, which supplies blood to the testicle, twists and cuts off the blood flow. This causes severe testicular pain and swelling, which can develop quickly. Without prompt treatment, the lack of blood flow can lead to permanent damage or loss of the testicle. It most commonly affects adolescents and young men but can occur at any age. The condition is considered a medical emergency because timely intervention is crucial to save the testicle. Symptoms often include sudden, intense pain and swelling in one testicle, sometimes accompanied by nausea or abdominal pain.

Testicular torsion is defined as the twisting of the spermatic cord leading to ischemia of the testis due to compromised arterial inflow and venous outflow obstruction. The primary mechanism involves abnormal fixation of the testis within the scrotum, often due to a congenital anomaly called the bell clapper deformity, which allows excessive mobility. This results in acute onset of severe unilateral scrotal pain and swelling. The condition is a urologic emergency because prolonged ischemia beyond 6 hours can cause irreversible testicular necrosis and loss of function. Clinical significance includes risk of infertility and psychological impact if orchiectomy is required. It is distinguished from other causes of acute scrotum such as epididymitis by its sudden onset and absence of systemic infection signs.