Testicular Issues: Concerns About Torsion and Sensitivity - Urology

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Testicular issues, particularly concerns about torsion, can be quite alarming, especially when accompanied by discomfort or unusual sensations. Let's address your questions systematically.

1. Can testicular torsion occur from rubbing the scrotum?
While it is unlikely that gentle rubbing of the scrotum during washing would directly cause testicular torsion, it is not impossible. Testicular torsion typically occurs when the spermatic cord, which supplies blood to the testicle, twists and cuts off its blood supply. This twisting can happen spontaneously or due to trauma, vigorous activity, or anatomical predispositions (such as a condition known as "bell clapper deformity," where the testicle is not securely attached to the scrotum). If you were to apply excessive force or engage in vigorous movement while rubbing, it could theoretically contribute to torsion, but this is not a common cause.

2. What does testicular torsion feel like?
Testicular torsion is often characterized by sudden, severe pain in the affected testicle, which may radiate to the lower abdomen or groin. The pain is typically sharp and can be accompanied by nausea and vomiting. However, as you mentioned having a sensitive nervous system, it is possible that you may experience discomfort or pain differently. Some individuals may have a milder presentation, especially if the torsion is intermittent or if there is a partial twist. In such cases, the discomfort might not be as intense but can still be significant. If you are experiencing persistent discomfort, it is essential to seek medical evaluation.

3. Does the cremaster muscle fail if torsion occurs? How long does it take?
The cremaster muscle is responsible for raising and lowering the testicles in response to temperature changes and other stimuli. In the event of testicular torsion, the cremaster muscle may initially contract in an attempt to protect the testicle, but if the torsion is not resolved quickly, the blood supply to the testicle can be compromised. The testicle can become ischemic (lack of blood flow) within a few hours, leading to irreversible damage. Generally, if torsion is not corrected within 6 hours, the risk of losing the testicle increases significantly, and after 12 hours, the chances of saving the testicle drop dramatically.

Given your symptoms of discomfort in the right testicle, it is crucial to err on the side of caution. If you continue to feel discomfort or if the sensation worsens, I strongly recommend seeking immediate medical attention. A healthcare provider can perform a physical examination and may order an ultrasound to assess blood flow to the testicle, which is a critical step in diagnosing torsion or other potential issues.

In summary, while your symptoms may not definitively indicate torsion, they warrant further investigation. Testicular torsion is a surgical emergency, and timely intervention can make a significant difference in outcomes. Please prioritize your health and consult with a healthcare professional as soon as possible.