Testicular Torsion: Symptoms, Diagnosis, and Treatment Options

Q: Testicular Torsion: Symptoms, Diagnosis, and Treatment Options

Hello： You don't need to worry, as this condition is unlikely to allow you to delay for long; if the testicle does not return to its normal position within a few hours, it could lead to testicular necrosis. <br>However, you should avoid attempting to manually reposition the testi

Testicular torsion

When I was in elementary school, I injured my left testicle, but I didn't pay much attention to it and just rested for a few days.
However, I still felt some discomfort, so I researched online and found that my symptoms resembled testicular torsion.
I attempted to manually reduce it myself, but it seemed to get worse, as I was unsure whether to rotate it clockwise or counterclockwise.
Eventually, it started to affect my daily life, so I went to see a doctor.
After an ultrasound, the doctor said everything was normal.
Later, I consulted another doctor who also said the condition was fine and advised me to take warm baths.
However, I still feel a noticeable swelling, and I have been rotating my left testicle on my own without knowing if I'm doing it correctly.
I'm very worried.
How should I resolve this? Do I need surgery?

Awei, 20~29 year old female. Ask Date: 2022/11/07

Dr. Du Shixi reply Urology

Hello: You don't need to worry, as this condition is unlikely to allow you to delay for long; if the testicle does not return to its normal position within a few hours, it could lead to testicular necrosis.
However, you should avoid attempting to manually reposition the testicle yourself, as this is not very helpful, although it is not too serious.
For now, just pay attention to your lifestyle, get plenty of rest, avoid prolonged sitting, and improve circulation.
If you experience swelling, redness of the skin, or pain, seek medical attention.
Wishing you good health.

Reply Date: 2022/11/07

More Info

Testicular torsion is a serious medical condition that occurs when the spermatic cord becomes twisted, cutting off the blood supply to the testicle. This condition is considered a surgical emergency and requires immediate medical attention to prevent permanent damage or loss of the affected testicle.

Symptoms of Testicular Torsion
The symptoms of testicular torsion can include:
1. Sudden, Severe Pain: This pain often comes on suddenly and can be intense. It typically occurs in one testicle, but may also radiate to the lower abdomen or groin.

2. Swelling: The affected testicle may become swollen and tender.

3. Nausea and Vomiting: Many individuals experience nausea and may vomit due to the severe pain.

4. Abnormal Position: The affected testicle may appear higher than the other testicle or may be in an unusual position.

5. Changes in Skin Color: The skin over the affected testicle may appear red or dark.

Diagnosis
Diagnosis of testicular torsion typically involves a physical examination and imaging studies. A healthcare provider will assess the symptoms and may perform a Doppler ultrasound to evaluate blood flow to the testicle. In some cases, an MRI may be used, but ultrasound is the most common and effective method for diagnosing this condition.

Treatment Options
The primary treatment for testicular torsion is surgical intervention. The surgery involves untwisting the spermatic cord and restoring blood flow to the testicle. If the testicle is viable, it can be saved. In cases where the testicle has died due to lack of blood supply, it may need to be removed.

1. Surgical Detorsion: This procedure involves untwisting the spermatic cord. It is usually performed under general anesthesia.

2. Orchidopexy: After detorsion, the testicle is typically secured to the scrotum to prevent future torsion. This procedure is called orchidopexy.

3. Pain Management: Post-operative care includes managing pain and monitoring for any complications.

Importance of Immediate Care
If you suspect you have testicular torsion, it is crucial to seek emergency medical care immediately. The longer the testicle is deprived of blood flow, the greater the risk of permanent damage. Ideally, treatment should occur within six hours of the onset of symptoms to maximize the chances of saving the testicle.

Your Situation
Based on your description, it seems you have experienced discomfort in your left testicle following an injury. While you have consulted with doctors and received normal ultrasound results, persistent discomfort and the act of attempting to manually correct the position of your testicle can be concerning. It is essential to avoid self-manipulation, as this can exacerbate the problem or cause further injury.

Given your ongoing symptoms, I strongly recommend that you seek a follow-up appointment with a urologist. They can perform a thorough evaluation, including a physical examination and possibly repeat imaging studies, to determine the cause of your discomfort. If there is any suspicion of torsion or other complications, they can provide the necessary surgical intervention.

In summary, while testicular torsion is a serious condition that requires immediate attention, your previous evaluations have indicated normal findings. However, due to your ongoing symptoms, further evaluation is warranted. Do not hesitate to seek medical advice, as early intervention is key to preventing complications.

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