Pediatric Testicular Torsion

Testicular torsion is a painful twisting of a boy’s testicles and spermatic cord. The spermatic cord is a set of nerves, ducts and blood vessels that leads from the groin to the testicles. Torsion can happen to one or both testicles. Torsion causes blood to not flow to the testicles. This can damage them. Treatment needs to be done right away to prevent long-lasting (permanent) injury to the testicles.

Testicular torsion in young boys and teen boys occurs when the testicles are not completely attached in the scrotum. This lets the testicles move more freely and twist. Torsion may happen during physical activity.

Testicular torsion in a baby happens when the sac around the testicles doesn’t attach to the scrotum.

Testicular torsion often occurs in boys ages 10 and older. It can also happen when a baby is growing in the mother's uterus, or shortly after a baby is born. The condition is sometimes seen in fathers, sons and brothers. This means it may be linked to a gene.

The severity of the symptoms depends on if the testicle is partly or fully twisted. Symptoms can occur a bit differently in each child. The scrotum may be:

• Painful (the pain is often very severe)
• Red
• Swollen
• Firm (in a baby)
• Bruised (in a baby)
• Closer to the groin

Your child may also have nausea and vomiting.

Testicular torsion is a surgical emergency. If you think that your son has testicular torsion, he should be taken to an emergency department right away for evaluation.

The symptoms of testicular torsion can seem like other health conditions. Make sure your child sees his healthcare provider, or is seen in the emergency department, for a diagnosis.

The healthcare provider will ask about your child’s symptoms and health history. They may also ask about your family’s health history. The provider will give your son a physical exam. He may also have tests, such as an ultrasound. This is a painless imaging test that uses sound waves to see the scrotum and testicles and check blood flow.

Testicular torsion often needs to be treated right away. The more severe the torsion, the more quickly treatment is needed. In some cases, the torsion may be untwisted by hand. But surgery is still needed to keep the testicle in place so torsion can’t occur again. To reduce the risk of long-term problems, surgery should be done within 6 hours of symptoms. Surgery can also help stop torsion from happening again.

Talk with your child’s healthcare providers about the risks, benefits and possible side effects of all treatments.

If the condition is not treated quickly, it can lead to loss of the testicle.

Testicular torsion is a medical emergency. If you think that your son has testicular torsion, he should be taken to an emergency department right away for evaluation.

After surgery, call the healthcare provider if your child has:

• Symptoms that don’t get better or get worse
• New symptoms