UROLOGY · CONDITIONS
Testicular Torsion
Twisting of the spermatic cord cutting off blood supply to the testis , a time-critical urological emergency. Surgery within 6 hours saves the testis.
ABOUT THIS CONDITION
What is Testicular Torsion?
Testicular torsion occurs when the spermatic cord twists, cutting off the blood supply to the testis. Without surgical detorsion within 4–6 hours, the testis undergoes ischaemic necrosis and cannot be saved. It most commonly affects adolescent males but can occur at any age. Sudden severe testicular pain must be treated as torsion until proven otherwise. Dr. Vipin treats testicular torsion as the highest surgical priority , immediate scrotal exploration, detorsion, assessment of viability, and bilateral orchidopexy are performed without delay to achieve the highest testicular salvage rates.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- Bell-clapper deformity , abnormal testicular attachment allowing torsion
- Adolescent growth spurt , rapid increase in testis size
- Increased testicular mobility within the tunica vaginalis
- Physical activity or trauma (less common)
- Sleeping position change triggering torsion
- Bilateral predisposition , contralateral testis equally at risk
CLINICAL DETAILS
KeyFacts
Do not delay for imaging if torsion is clinically suspected , proceed directly to theatre.
>90% if operated within 6 hours. Falls to 50% at 12 hours. Near 0% at 24 hours.
Both testes are fixed with permanent sutures , prevents recurrence on either side.
A non-viable testis must be removed to prevent autoimmune damage to the other testis.
Testicular prosthesis offered after orchidectomy for psychological and cosmetic benefit.
Contralateral testis is always fixed at the same operation , it is equally at risk.
HOW WE TREAT IT
Treatment Approach
Emergency Scrotal Exploration Detorsion Bilateral Orchidopexy
The only treatment for testicular torsion , immediate scrotal exploration, untwisting of the cord, assessment of viability, and permanent fixation of both testes to prevent recurrence on either side.
- 1
Emergency Recognition
Any sudden severe testicular pain is a torsion emergency. History and examination are sufficient , no imaging should delay theatre transfer.
- 2
Immediate Surgery
Emergency scrotal exploration is performed within the hour. The cord is untwisted and the testis assessed for viability based on colour and bleeding.
- 3
Orchidopexy or Orchidectomy
If viable, the testis is fixed to the tunica with permanent sutures. The contralateral testis is fixed simultaneously. Non-viable testis is removed.
- 4
Recovery
Discharged within 24–48 hours. Full recovery in 1–2 weeks. Testicular viability confirmed by follow-up Doppler ultrasound at 6 weeks.
AVAILABLE TREATMENTS
Treatment Options
Emergency Scrotal Exploration Detorsion Bilateral Orchidopexy
Immediate scrotal surgery , detorsion and bilateral permanent orchidopexy. The only treatment. Time is the testis.
Orchidectomy (if non-viable testis)
Removal of an irreversibly infarcted testis to prevent autoimmune antibody production that could damage the surviving contralateral testis.
COMMON QUESTIONS
Frequently Asked
Not sure about your condition?
Compassionate, confidential consultations — Book your appointment today.