What is Testicular Torsion?

As it's International Men's Health Awareness Week, Toni Bedward, Solicitor in our Clinical Negligence Department answers some frequently asked questions about the risks and symptoms of testicular torsion after representing multiple Claimants in relation to a delay in diagnosis and treatment.

What is testicular torsion?

Testicular torsion is a condition in which a testicle twists, restricting the necessary blood flow to the area, resulting in sudden and often intense pain and swelling. It is a time sensitive emergency which requires urgent treatment. Otherwise, the testicle may die and may have to be removed.

Testicular torsion can happen at any time. It can occur as a result of an injury to the scrotum, partaking in sports or physical activity, it can also happen when you are asleep or for no specific reason at all.

Some people can suffer from intermittent testicular torsion where the testicle twists slightly and then untwists over several periods. This is still dangerous as the testicle will likely end up twisting completely.

Who can be affected by testicular torsion?

Studies have found that testicular torsion is common in babies, toddlers, and teenagers aged 12-18 but testicular torsion can happen to men at any age. Although the condition may be more common in babies it can be more severe in adults. National clinical guidance suggests that testicular torsion should be suspected as a diagnosis in any patients under 30 with acute onset of testicle pain.

What are the symptoms of testicular torsion?                           

Some of the symptoms of testicular torsion include:

• Sudden and severe testicle pain (usually within a couple of hours but often more quickly),

• Lower abdominal pain,

• Swelling of the testicles or scrotum,

• Feelings of nausea and vomiting.

Unfortunately as the pain eases, this can suggest that the testicle has started to die. When blood flow has been restricted for too long, the nerve endings in the testicle start to die which is why the pain eases off. It is better to get the pain checked out as soon as possible.

What should I do if I suffer from sudden and severe testicle pain?

If you or anyone you know begins to experience the symptoms listed above, it is important to go to hospital straight away. It is best to attend your local Accident & Emergency (A&E) if possible, as surgical exploration is the only real way of diagnosing and treating testicular torsion. Urgent Care Centre’s generally will not have the surgical facilities to undertake the exploration, or the associated urology specialists, so you should save time and head straight to A&E. The longer that blood flow to the testicle is restricted, the more chance there is of losing the testicle.

At hospital you will be examined by a clinician. If it is thought that you are suffering from testicular torsion it is likely you will need to undergo surgical exploration. This is thought to be a fairly small and quick operation. If you are suffering from testicular torsion and you undergo surgery quickly enough, the testicle can usually be untwisted and it will be ‘fixed’ into position so that it cannot twist again. If the testicle has already lost all blood flow it will usually be removed. There is usually the option to have a prosthetic testicle implanted for cosmetic appearance.

Unfortunately, there appears to be a common misconception that a testicle can only be saved if it is operated on within 4-6 hours. Whilst there is literature to suggest that many testicles can be saved outside this period, it is best to seek treatment immediately.

Are there any long term complications?

If action is not taken quickly enough, you could lose a testicle.

It is generally accepted that losing one testicle should not have an adverse effect on your fertility as the other healthy testicle will usually compensate. However, for patients with only a solitary testicle, the loss of that testicle could take away all chance of being able to have children naturally.

What are the problems?

There appears to be a lack of awareness from clinicians and the general public in relation to the signs and symptoms of testicular torsion and the fact that it is an emergency. According to one study the cause of testicular loss is a delay in seeking medical attention in 58% of cases, a wrong initial diagnosis by the GP in 29% and delayed treatment at the referred hospital in 13%.

Earlier diagnosis and treatment can be achieved by educating medical clinicians but earlier presentation also requires educating the general population. Understandably, young men may feel embarrassed to discuss testicle pain, but it is very dangerous not to do so.

In 2021, the Urology Foundation ran a ‘Save the Ball’ campaign whereby they tried to raise awareness of testicular torsion.Toni is currently representing 3 Claimants who have suffered a delay in diagnosis and treatment of testicular torsion across 3 different hospital Trust’s which suggests that there is still a lack of awareness of the condition and the serious consequences if treatment is not provided in time.

This men's health awareness week, please discuss the signs and symptoms of testicular torsion with those around you to help spread awareness of this time sensitive medical emergency.

Please contact Toni Bedward by clicking the ‘contact us’ button to email her directly. You can also call Toni directly on 020 3551 8456 at our Wallington Office or visit our Clinical Negligence Page here.