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Testicular Torsion (Twisted Spermatic Cord)

About Testicular Torsion

Testicular torsion is a medical condition characterized by rotation of the testes following twisting of the spermatic cord inside the scrotum. Stoppage of blood supply to the testes presents as severe swelling and pain the testis. Although men of any age may suffer from this condition usually young boys between the age group of 12 and 16 are at increased risk.

The main cause of testicular torsion is a developmental defect where the testis is not adequately attached to scrotum allowing free movement of the testes and thereby twisting the spermatic cord including the blood supplying vessels. Early diagnosis and prompt surgical intervention is essential to preserve testicular tissue from death due to lack of blood supply.

Testicular Torsion Symptoms

The common presenting symptoms include sudden onset of severe pain and swelling of the scrotum, often there may be associated lower abdominal pain, nausea and vomiting along with low grade fever. The affected testis may appear to be positioned at a higher region than normal. Patient also complains of lightheadedness and blood in the semen.

Testicular torsion, if not managed immediately usually within 6 hours, may result in a severe degree of damage or even death of the tissue due to lack of blood supply. This damaged or dead testis is to be removed surgically. In many cases loss of one sided testicular function may lead to incapability of the man to father children.

Causes of Testicular Torsion

Testes are the pair of male reproductive organs situated in the sac like structure scrotum, just below the penis. The main functions of testes are to produce the male hormone testosterone which is responsible for all the male pattern of physical or mental characteristics and production of sperm which fertilize the ovum in the female body. The spermatic cords are the cord like structures which carry the vas deferens, tube like structure which transports the sperm, nerves and blood vessels from the abdomen to the testes. Each testis is supplied by its one spermatic cord.

Sometimes the testis may rotate on this axis (spermatic cord) eventually twisting the cord and interrupting the blood flow through the vessels. Poor or complete lack of blood supply to the testis for more than 6 hours may lead to irreversible damage to the tissue of the testis (ischemic injury). In many of the male patients (about 90%) suffering from testicular torsion a developmental defect (bell-clapper deformity) may be responsible. Normally the testis is attached to the back of the scrotum by mesorchium, in many men this lining is deficient leading to unhindered rotation (free floating) of the testis inside the scrotal sac.

In men with this deformity often the both testes are liable to torsion. Other than developmental defect some other conditions may lead to testicular torsion like excessive physical activity, trauma to the scrotal sac, exposure to extreme cold temperature, rapid growth in the pubertal age group and during sleep.

Testicular Torsion Treatment

Testicular torsion should be considered as a medical emergency once the signs and symptoms are recognized. Immediate surgical correction of twisting of the cord is the mainstay of treatment. If surgery is performed within 6 hours there is 95% chance of complete preservation but after 24 hours the chance rapidly declines.


Posted by in Men's Health

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