Testicular Torsion: Symptoms, Risks, and Treatment Options - Urology

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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 prompt treatment is crucial to prevent permanent damage or loss of the affected testicle.


Symptoms of Testicular Torsion
The classic symptoms of testicular torsion include:
1. Sudden, severe pain in one testicle, often accompanied by swelling.

2. Nausea and vomiting may occur due to the intense pain.

3. Abnormal position of the testicle, which may appear higher than usual or at an unusual angle.

4. Painful urination or changes in urinary habits.

5. In some cases, there may be no pain at all, especially if the torsion is intermittent or if the testicle has partially twisted and then untwisted itself, which can lead to a phenomenon known as "bell clapper deformity."

Risks Associated with Testicular Torsion
The primary risk associated with testicular torsion is the loss of the testicle due to prolonged lack of blood supply. If the blood flow is not restored within 6 hours, the risk of permanent damage increases significantly, and after 12 hours, the chances of saving the testicle drop dramatically. Other risks include:
- Infertility, if both testicles are affected or if one testicle is lost.

- Chronic pain or discomfort in the affected area.


Treatment Options
The definitive treatment for testicular torsion is surgical intervention. The surgery typically involves:
1. Detorsion: The twisted spermatic cord is untwisted to restore blood flow to the testicle.

2. Fixation (orchidopexy): The testicle is secured to the scrotum to prevent future torsion. This is usually done on both sides, even if only one testicle was affected, to prevent torsion in the other testicle.


Your Situation
Based on your description, it appears that you have experienced multiple episodes of testicular torsion, particularly on the left side. The fact that you have been able to manually untwist the testicle is concerning, as it indicates that the torsion is recurrent. While you may not have experienced severe pain during the first episode, the presence of discomfort during the latest episode suggests that the condition is becoming more serious.

Given the risks associated with testicular torsion, it is highly advisable to seek medical attention as soon as possible. A urologist can perform a physical examination and may order imaging studies, such as an ultrasound, to assess blood flow to the testicle. If torsion is confirmed, surgical intervention will likely be necessary to prevent complications.


Conclusion
In summary, testicular torsion is a medical emergency that requires prompt evaluation and treatment. Given your history of recurrent torsion, it is crucial to consult a healthcare professional immediately. Do not wait for the symptoms to worsen, as timely intervention can save your testicle and prevent long-term complications.