Yes, a testicle can get "turned around," a serious medical condition called testicular torsion, where the spermatic cord twists, cutting off the testicle's blood supply, causing sudden severe pain and requiring immediate emergency surgery to save the testicle. This condition is most common in teens and young men but can happen at any age, often linked to an anatomical trait allowing the testicle to swing freely.
In most individuals, the testicle rotates between 90-180 degrees and compromises blood flow. Complete torsion is rare and quickly decreases the viability of the testes.
Signs and symptoms of testicular torsion include: Sudden, severe pain in the scrotum — the loose bag of skin under your penis that contains the testicles. Swelling of the scrotum. Abdominal pain.
What are the symptoms of testicular torsion?
The term Bell Clapper Testes describes testes that sit horizontally in the scrotum. Testicles should normally sit up 'vertically' rather than horizontally. It is a congenital abnormality of the testicle. The abnormality normally affects both testes.
With torsion of the left testis, hold the testicle with the right thumb and forefinger and then rotate the testicle clockwise 180 degrees. This manipulation may need to be repeated 2-3 times, because testicular torsion may involve rotations of 180-720 degrees.
Common signs and symptoms of testicular torsion
Symptoms might include: Sudden, severe pain in one testicle. Swelling or tenderness in the scrotum. A high-riding testicle or one that sits at an unusual angle.
What can be mistaken for testicular torsion?
Warning signs to look out for
Testicular torsion usually comes on suddenly and causes: Severe pain in one testicle that might start during physical activity, after an injury, or while sleeping. Swelling of the scrotum. Abdominal pain.
The most common sign of testicular torsion is sudden, severe pain on one side of the scrotum. The testes should be about the same size. If one side quickly becomes larger than the other, this can be a problem. Change in scrotum color, especially redness or darkening, is also a problem.
Get medical care right away if you have: Sudden, serious testicle pain. Testicle pain along with nausea, fever, chills or blood in the urine.
Differential Diagnosis
Various scrotal-related pathologies may clinically mimic testicular torsion and present with an acute scrotum. These include scrotal cellulitis, gangrene, edema, scrotal abscess, and fat necrosis secondary to trauma.
Sometimes, testicular torsion can cause a sudden pain that goes away without treatment. This happens if your testicle twists and then untwists on its own. If this happens, see a doctor as soon as possible. You may need surgery to prevent it happening again.
As mentioned above, anatomical abnormalities and cremasteric contractions during ejaculation may cause torsion by rotating the testes medially [4], like in our case. Therefore, the masturbation should be kept in mind as a reason of testicular torsion in adolescence period.
About 50 kilograms (roughly 110 pounds) of direct force can cause a testicle rupture. Signs and symptoms of blunt trauma might include: Sudden and severe testicular pain. Scrotal swelling.
Testicular torsion occurs in all age groups, but it most commonly occurs after birth and between 12 and 18 years of age.
You'll feel a sudden, possibly severe pain in your scrotum and one of your testicles. The pain might increase and decrease but generally won't go away completely. Other symptoms include: swelling, especially on one side of the scrotum.
Testicle survival after testicular torsion was significant beyond the commonly held six-hour time frame and even after more than 24 hours of ischemia. And cumulative testicular salvage (based on 2,116 patients) is 90.4% in the first 12 hours. From 13 to 24 hours survival is 53.1% and after 24 hours survival is 18.8%.
Diagnosis
Inguinal hernias and testicular torsion can have similar symptoms in men. “With both sexes, asking questions can help you pinpoint with more clarity what's going on and what treatment you need,” says Sachs.
See a GP if:
The observation that the left testis is often lower than the right is a common phenomenon in many men. This anatomical variation can be influenced by various factors and is generally a normal aspect of human anatomy. Understanding why this occurs can provide insights into normal testicular development and function.
How should my testicles look and feel? A healthy testicle has a firm and smooth surface, but doesn't feel hard. You might have one testicle slightly bigger than the other. This is normal.
If your son has a retractile testicle, the testicle originally descended as it should, but doesn't remain in place. Symptoms of a retractile testicle include: The testicle may be moved by hand from the groin into the scrotum and won't immediately retreat to the groin.
Typically, we recommend surgery to fix the testicles within the scrotum so they can't twist in the future. The risk of not treating intermittent testicular torsion is having an episode where the testicle twists and does not untwist, leading to the loss of the testicle.