What causes testicular torsion?

what causes testicular torsion

Testicular torsion is a surgical emergency, common in children, and has symptoms that are confused with other conditions. Timely detection and treatment of testicular torsion help to avoid serious complications such as testicular necrosis, and testicular atrophy. Let’s find out what causes testicular torsion in this article!

Testicular torsion is a pathological condition that occurs when the spermatic cord is affected by twisting around the axis, causing obstruction, background edema, and congestion, and if not detected and treated early, leads to a serious condition called necrosis, testicular. The definition of testicular torsion refers to the pathology in the testicular organ, and according to the anatomical classification, it is called individual testicular torsion.

Testicular torsion is an emergency condition of nephrology, urology, or andrology, a common disease in young men with an incidence of about 1 in 4000 men under the age of 25 years and is the main reason why men undergo orchiectomy is the leading necrosis complication, after serious trauma to the genital organs.

Testicular torsion is a vascular emergency, so it should be detected and treated 6 hours from the onset of pain in the groin area. The testicles will be necrotic and require orchiectomy, which will partially affect male fertility. In addition, it can affect psychology, causing men to lose confidence later when having sex, reducing libido, and erectile dysfunction.

Symptoms of testicular torsion

Patients with testicular torsion often have symptoms such as sudden and severe pain in one testicle (due to the testicle rotating around its axis, causing sudden blockage of the spermatic cord, reducing or completely blocking blood flow to the testicle), the scrotum is swollen, and painful, pain may radiate upward, and the twisted testicle may be in a higher position than usual.

Testicular pain can suddenly go away without treatment because a change in the patient’s position helps the testicle to untwist on its own.

Testicular torsion is essentially torsion of the spermatic cord (blood vessels and vas deferens) leading to testicular ischemia and damage, necrosis. If left torsion for too long, the testicle can be permanently damaged, affect fertility or have to be removed.

What causes testicular torsion?

Currently, the exact cause of testicular torsion is still unknown. It can happen when a man has an injury, is sleeping, or working. Therefore, the risk factors that can lead to common testicular torsion are as follows:

  • Congenital abnormalities of the testicular cord structures
  • Movable testicles are seen in the postpartum period when the child has not completely descended into the scrotum
  • Injury during exercise or daily activities
  • Cold weather times

Diagnosis of testicular torsion

The doctor will rely on:

Clinical symptoms: Severe and sudden torsion of the lateral testicle, higher than normal, lateral scrotum torsion and pain, loss of scrotal skin reflexes on the side of the torsion (by mild stimulation of the medial side of the lateral thigh If the testicle is normal, the testicle shrinks; if the testicle is torsion, this reflex does not occur).

Paraclinical tests such as color Doppler ultrasound can show ischemia of the testicle, epididymis, and spermatic cord, and damage due to testicular torsion.

How is testicular torsion treated?

The golden time for treatment of testicular torsion is only the first 6 hours from the time of pain symptom. If intervention is before 6 hours, 100% of patients can save testicles. Come between 6-12 hours, the chance of saving testicles is only 50% and in 12-24 hours, only 20% will be saved.

More than 24 hours usually won’t save the testicle. It is worth noting that due to late detection, many children with testicular torsion come to the hospital when the testicle is necrotic and has to be removed. Children who have one testicle removed will have an effect on fertility and male hormones.

Testicular torsion is a less complicated and less invasive surgery. The surgery is carried out as follows: the doctor will first make an incision in the scrotum; then untwist the spermatic cord; Stitches fix the testicle to the scrotum to prevent the testicle from being rotated.

In fact, it is still difficult to detect the disease at an early stage, because patients are subjectively late to the examination. In case the patient comes to the clinic early, it is possible to completely remove the torsion manually, but the risk of recurrence for the patient is very high, so the optimal solution is surgery to remove the torsion and fix the testicle.

For patients who are detected late after 24 hours, emergency surgery is definitely something male urologists must do, but the possibility of preserving this testicle is very low.

During surgery, doctors will try to do everything to preserve the testicle on the side of torsion such as:

  • Warm testicles with physiological saline
  • Use local anesthetic drops on the testicles
  • Incision of the white capsule of the testicle to relieve pressure
  • Orchiectomy only when all conservative measures fail

In addition, due to many different reasons, the remaining testicle will often be fixed by the surgeon during surgery to prevent torsion of the remaining testicle later.

Final thought

In summary, testicular torsion is a surgical emergency, the patient needs timely surgical intervention. Therefore, when patients have sudden pain symptoms in the scrotum, it is necessary to quickly go to a specialized facility for accurate diagnosis and timely treatment.

Top News hopes this article can help you learn more about what causes testicular torsion and wishes your health is always good!

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