Testicular Torsion

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KEY POINTS

• Sometimes before birth, your baby boy’s testicles do not move down from in the belly into the scrotum, or just one moves into the scrotum. Sometimes, the testicle twists as it moves, which reduces the blood flow to the testicle. The testicles and scrotum are part of the male reproductive organs.
• In a newborn baby, the testicle that has not moved into the scrotum or that has twisted in the scrotum may have to be removed because of the risk of infection. An older child will need surgery even if the emergency healthcare provider is able to untwist the testicle, to prevent it from happening again.
• Follow the full course of treatment prescribed by your child’s healthcare provider. Ask your child’s provider what symptoms or problems you should watch for and what to do if your child has them.

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What is testicular torsion?

Testicular torsion is when the testicle twists in the scrotum, which reduces the blood flow to the testicle. The testicles are in a sac of loose skin, called the scrotum or scrotal sac, which is below and behind the penis. The testicles and scrotum are part of the male reproductive organs.

Testicular torsion in a newborn baby means that the condition is found at birth or within the first few weeks of a baby’s life. It is a rare condition in newborn boys.

Testicular torsion can happen at any age but is more common at birth and during early teen years.

What is the cause?

Late in pregnancy, your baby boy’s testicles move from low in his belly, where they developed, into his scrotum. Sometimes his testicles do not move down, or just one moves into the scrotum. Sometimes, the testicle twists as it moves, which reduces or cuts off the blood supply to the testicle.

In an older boy, the testicle can twist if the spermatic cord, which holds the testicle in place, is too long. When the testicle twists, it causes the spermatic cord and blood vessels to twist. The twist causes reduced blood to the area, and the testicle can be damaged badly unless your child gets quick treatment.

The twisting can happen while exercising, sleeping, masturbating, having sexual activity, standing, or walking.

What are the symptoms?

In a newborn boy, the testicular torsion may be diagnosed when the baby is born. Torsion can occur in the first weeks after birth also.

Boys have a greater risk of testicular torsion at the time of puberty. The most common symptom is sudden pain on one side of the scrotum.

Symptoms may also include:

• Nausea and vomiting
• Scrotal redness, bruising, or hardness especially on one side
• Swelling of one side of the scrotum, or unusual irregular shape to the scrotum

How is it diagnosed?

Your baby’s healthcare provider will examine your baby at birth and at your regular office visits after birth.

For your older child, his healthcare provider will ask about his symptoms and medical history and examine him. Tests may include:

• Ultrasound, which uses sound waves to show pictures of and blood flow to the testicles
• Urine tests to check for infection
• Blood tests

How is it treated?

In a newborn baby, the testicle usually has to be removed because of the risk of infection.

Your older child will need surgery even if the emergency healthcare provider is able to untwist the testicle, to prevent it from happening again.

• Your child’s healthcare provider will make a cut in his scrotum or in his abdomen to repair the torsion.
• Your child’s provider will untwist the testicle and cord and add stitches to keep the testicle from twisting again.
• If the testicle is damaged beyond repair from lack of blood or infection, it will be removed during surgery.

Your child’s healthcare provider will check your child’s other testicle also. Your child’s healthcare provider will use stitches to hold the other testicle in place to prevent it from twisting.

How can I take care of my child?

• Follow the full course of treatment prescribed by your child’s healthcare provider. Ask your child’s provider:
  • How and when you will get your child’s test results
  • How long it will take your child to recover
  • If there are activities your child should avoid and when your child can return to normal activities
  • How to take care of your child at home
  • What symptoms or problems you should watch for and what to do if your child has them
• Make sure you know when your child should come back for a checkup.