Testicular Torsion

Testicular torsion is a more important topic for your son’s health and well being than even the subject of how to fix a bent penis is to you.

The reason is, your son could lose one of his balls if you don’t recognize it and know what to do about it.

It’s one of those topics that is serious and not too familiar to the general public.

Testicular Torsion is most frequent in younger men, but you, as their Dad, can keep your son(s) from suffering from the possible serious consequences of it with some simple knowledge ahead of time.

What Exactly Is It?

Testicular torsion is what happens when a testicle (testes, ball, orchis, nut...) rotates on the spermatic cord. The spermatic cord connects the ball to the rest of the body and provides the blood flow to it.

testicular torsion diagram

It is also called Testicular Twisting, Testicular Ischemia, and Torsion of the testes.

When the cord rotates and twists, the blood supply is greatly diminished or even cut off completely.

This suffocates the orchis and if the cord is not untwisted within a short period of time (2-24 hours) the orchis will be strangled to death and have to be removed.

A Serious Medical Emergency!

Testicular torsion can happen to males of any age, but is most common in new borns and boys up to about 18 year olds.

It is a serious condition that could cause the loss of the ball if not treated within hours of the occurance.


Unfortunately, for most young men and most boys, talking about their private parts to their parents (especially their Moms) is too embarrassing.

Pain in the genitals is usually nothing more than a brief discomfort. But when it is more painful and lasts more than a brief time it could mean testicular torsion has occurred.

Testicular torsion is a serious medical emergency. It usually requires immediate medical attention in order to keep the orchis alive.

It is important to teach your son(s) that there is no need to keep secrets when they are experiencing pain in their genitals.


The “authorities” don’t really know why it occurs. Unfortunate, but true.

The condition can occur after strenuous exercise. Or, after a trauma to the scrotum. It can even happen while a person is sleeping. Often, however, the cause isn't known.

Most Common Occurances

Testicular torsion occurs most frequently in boys and men who have a genetic condition called Bell Clapper Deformity.

This is a condition where the balls are not anchored to the scrotum. It is an inherited trait. They are kind of suspended like a clapper in a bell (hence the name).

This can also happen from a trauma to the scrotum that causes the balls to detach from the scrotum.

This leaves them free to move around. When they spin and the spermatic tube gets twisted you have what is called testicular torsion.

Sometimes (rarely) they will untwist by themselves. But, unless they are anchored to the scrotum (surgically) they can and often do twist again.

testicular torsion

The problem happens more frequently on the right side. But, can happen on either side.

If it lasts for only 8 hours (you can judge by the amount of time pain has been present) there is a 50% chance that the orchis will be suffocated (from cut off blood flow) and die. It will then require surgical removal.

That is how urgent prompt medical attention is. This condition is NOT something you wait a day, or sleep on, to see what will happen.

After 24 hours, the chance of saving the ball is only about 10%.

testicular torsion after 1 hr

1 hour of torsion

testicular torsion after 4 hours

4 hours of torsion

testicular torsion, dead testicle and healthy testicle

Dead (on left) from Torsion

Testicular torsion should be suspected in any boy with severe pain in the testicles or scrotum.


Immediate medical attention should be sought.

There is no time to waste when this condition is suspected. Prompt medical diagnosis (a trip to the hospital emergency room) and treatment are very important.

How Can You Tell?

The condition, or possibility of it, does not require a genius to detect.

First there will be pain that lasts. Often very severe pain. That should be warning enough.

Swelling in the ball and/or scrotum will often be present. Discoloration may also be present. One nut may appear higher than the other.

testicular torsion in children

Symptoms may also include nausea and vomiting may occur. As well as abdominal pain.

Sudden pain in a testes that goes away without treatment may also be a symptom. This happens when it twists and then untwists by itself. Unless it is secured to the scrotum, however, the problem can recur at any time in the future.

Eventually, it may not untwist after twisting and then serious complications may follow because the patient waits too long to seek correct medical treatment.

Your son will probably have felt a sudden, and maybe severe pain in his groin and/or one of his nuts. This pain may get worse. Possibly, it may subside. But it usually won't completely go away.

Acute pain and swelling that is anything more than brief should be enough to get you and your boy rushing off to the Emergency Room at your hospital.

Permanent Sexual Damage

Testicular torsion followed by testicle removal is all too common because: most boys do not feel comfortable talking to their parents about pain in their genitals. This is tragic.

If you have children, healthy sexual conversation should be encouraged.

That way possible a very serious problem like this won’t be kept a secret by your boy, and, the situation can be handled before it becomes so serious that he suffers permanent sexual (and the corresponding psychological) damage.

Immediate Treatment Is Necessary

This is considered a medical emergency. This means, immediate surgery is usually required to save the orchis.

Sometimes, but rarely, the ball can be untwisted and the blood circulation restored to normal without surgery.

However, surgery will still be needed to secure the balls to the scrotum so that it does not happen again.

When Surgery Is Necessary

This surgery, however, is quite simple and done on an outpatient basis.

Basically the scrotum is cut open and the twisted spermatic cord is untwisted. Then the testicles (both usually will require it) are anchored to the scrotum so they do not twist again in the future.

After the surgery the patient will need to avoid all sexual activity and strenuous activity for a few weeks. Your doctor will be able to tell him when it will be safe for him to return to his normal activities.

If Testicular torsion had been in place too long, and the doctor had to remove a testicle, the young man will still normally be able to father children later in life with just one testicle.

It is also important to let him know that he will still be able to have normal sexual relations, have a normal sex life, and father children with just one testicle.

Avoiding The Risks

While the signs and symptoms of testicular torsion may be caused by some other condition or trauma, if this condition actually is present, prompt treatment can prevent severe damage or loss of the ball.

Young men and boys have to learn that pain in their sexual parts can be serious and should not be ignored.

And, that talking about it is nothing to be embarrassed about.

Avoiding Serious Consequences

Ignoring sexual pain and just hoping it goes away can cause serious consequences.

So, please, talk with your sons. Let them know it is OK to talk with you if they ever have a sexual pain problem.

Reinforce in them the old saying: “It’s better to be safe than sorry.”

Unlike a bent penis, which you can work on in your own time, testicular torsion is a medical emergency. (As is a broken penis.) If left too long testicular torsion can cause the ball to die and need to be surgically removed.

Be Well.....

~ William