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Paediatric testicular torsion

OVERVIEW

Testicular torsion is a medical emergency that arises when the spermatic cord, which supplies blood flow to the testicles, becomes twisted, resulting in the cessation of blood supply to the testicle. This condition can lead to permanent damage to the testicle or even loss of the testicle if not treated promptly.

It's important to note that testicular torsion is a rare condition, but it can occur at any age, and it's more common in adolescents and young adults. If your child experiences sudden and severe pain in the scrotum, seek immediate medical attention.

Symptoms of testicular torsion

The symptoms of testicular torsion can include the following:

Sudden and severe pain in one testicle or the scrotum
Swelling and redness of the scrotum
The testicle may appear higher than normal or exhibit a twisted appearance.
Nausea and vomiting
Abdominal pain
Difficulty urinating

It's important to note that not all of these symptoms may be present in all cases of testicular torsion. However, sudden and severe pain in the scrotum is usually the most common symptom. If you encounter any of these symptoms, it's vital to urgently seek medical attention, as testicular torsion is a medical emergency and mandates prompt treatment to prevent irreversible damage to the testis.

Treatment

Prompt treatment is crucial in cases of testicular torsion, as it is a medical emergency that can result in permanent damage to the affected testicle. The primary aim of treatment is to restore blood flow to the testicle as soon as possible. Treatment options for testicular torsion include the following:

Manual detorsion: This involves manually untwisting the spermatic cord to restore blood flow to the affected testicle. This procedure is typically performed by a healthcare professional, such as a paediatric surgeon.
Surgery: If manual detorsion is unsuccessful or if the testicular torsion is severe, surgery may be necessary. During surgery, the twisted spermatic cord is untwisted, and the affected testicle is examined to determine if it has sustained any damage. If the testicle is damaged beyond repair, it may need to be removed (orchiectomy).
Pain medication: Pain medication, such as paracetamol or ibuprofen, may be prescribed to help manage pain and discomfort.

It is crucial to seek immediate medical attention if testicular torsion is suspected, as prompt treatment is necessary to save the affected testicle. If left untreated, testicular torsion can lead to permanent damage or loss of the testicle.

REQUEST A CONSULTATION

Dr Mangray, the founder of KZN Specialised Paediatric Surgical Service, and his associates, Dr Ngobese, Dr Govender and Dr Dube-Zvirikuzhe, have a well-established reputation for caring for children right until late adolescence.

FREQUENTLY ASKED QUESTIONS

FAQ

1How is testicular torsion diagnosed?

Testicular torsion is diagnosed based on a physical exam, medical history, and imaging study such as a Doppler ultrasound.

2Are there any long-term complications of testicular torsion?

In some cases, testicular torsion can lead to long-term complications such as infertility, chronic pain, or erectile dysfunction. However, prompt treatment can help minimise the risk of these complications.

3Who is at risk for testicular torsion?

Testicular torsion is more common in adolescent males and young adults. It's also more common in those with a family history of the condition.