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A. Testicular torsion occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum. The reduced blood flow causes sudden and often severe pain and swelling.
Testicular torsion is most common between ages 12 and 18, but it can occur at any age, even before birth.
Testicular torsion usually requires emergency surgery. If treated quickly, the testicle can usually be saved. But when blood flow has been cut off for too long, a testicle might become so badly damaged that it has to be removed.
A. Signs and symptoms of testicular torsion include:
Young boys who have testicular torsion typically wake up due to scrotal pain in the middle of the night or early in the morning.
A. The treatment involves surgical exploration.
This involves examination of the testis via a scrotal incision, untwisting of the affected testis and fixation of both testes in the scrotum to prevent twisting in the future.
A. The alternative includes Observation which risks loss of the testis and may also cause reflex damage to the other, normal testis.
This procedure is usually performed following an emergency admission and is best carried out within four hours of the onset of symptoms.
You will be asked not to eat or drink before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy.Please be sure to inform your urologist in advance of your surgery if you have any of the following:
o Blood thinners/ anti-platelets i.e. Warfarin, ecosprin, clopidogrel etc
o Anti-epileptics like phenytoin, valproate etc
A. Either a full general anaesthetic (where you will be asleep throughout the procedure) or a spinal anaesthetic (where you are awake but unable to feel anything from the waist down) will be used. All methods minimise pain; your anaesthetist will explain the pros and cons of each type of anaesthetic to you.The surgeon will explore both your testicles through an incision in the scrotum. If twisting of the testicle is confirmed, the testicle will be untwisted and both testicles fixed in the scrotum to prevent recurrence of the twisting.
A. You may experience discomfort for a few days after the procedure but painkillers will be given to you to take home. Absorbable stitches are normally used which do not require removal.
The average hospital stay is two days following emergency admission.
A. Most procedures have a potential for side effects. You should be reassured that, although all these complications are well recognised, the majority of patients do not suffer any problems after a urological procedure.
A. When you leave hospital, you will be given a discharge summary of your admission. This holds important information about your inpatient stay and your operation.
The groin and scrotum may be uncomfortable for seven to 10 days. Simple painkillers will usually relieve this discomfort.
You are advised to take 10 to 14 days off work and to refrain from vigorous exercise (including sport) for six weeks.
A. If you develop a temperature, increased redness, throbbing or drainage at the site of the operation, please contact your urologist.
A. A follow up outpatient appointment will be scheduled in first week after discharge followed by an appointment at six to eight weeks after the operation.