Doctor's Notes on Testicular Torsion
Testicular torsion is caused by the twisting of the spermatic cord, which results in a loss of blood flow to the testicle. It is a surgical emergency that can result in the loss of the affected testicle if not treated promptly. The most common cause of testicular torsion is an anatomic abnormality present in some males called the bell clapper deformity. This condition allows the spermatic cord to twist more easily. The twisting (torsion) can occur spontaneously or may be associated with trauma. Testicular torsion is the most common cause of testicle loss in adolescent males. It is seen most frequently in the 12 to 18-year-olds, and most cases occur in men under age 30.
Symptoms of testicular torsion include excruciating one-sided testicular pain with sudden swelling. Since the cord structures twist (like the strings of a puppet), the testicle elevates as well. Other symptoms of testicular torsion include nausea, vomiting, abdominal pain, and fever.
Testicular Torsion Symptoms
Testicular torsion is characterized by excruciating one-sided testicular pain, with sudden swelling. Since the cord structures twist (like the strings of a puppet), the testicle elevates as well. Patients may have nausea and vomiting. Patients may also have abdominal pain. There may be a history of previous testicular pain. Fever may also accompany the testicular pain.
Testicular torsion is seen most frequently in the 12-18-year-old age group, and most cases occur in men under 30 years of age. However, it can occur at any age, including newborns.
Testicular Torsion Causes
The cause of the majority of cases is the bell clapper deformity, an anatomic abnormality that is present in some males. This anatomical condition allows the spermatic cord to twist more easily, resulting in compromise of the blood supply to the testicle. This can occur spontaneously or may be associated with trauma. There is no way to detect this deformity. In significant number of men who have this anatomical abnormality will have it in both testicles.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.