Groin and genital area · emergency
Testicular torsion in children and teenagers
An urgent condition in which the testicle rotates on itself, causing twisting of the spermatic cord.
Testicular torsion
Testicular torsion is an urgent condition in which the testicle rotates on itself, causing twisting of the spermatic cord, the structure that contains blood vessels, nerves and the vas deferens.
When the cord twists, blood flow to the testicle may be reduced or interrupted. For this reason, testicular torsion requires an urgent surgical assessment: if not treated quickly, it can cause ischaemia of the testicular tissue and, in the most severe cases, loss of the testicle.
Symptoms and signs to look out for
The main warning signs are:
Causes or associated factors
Testicular torsion may be favoured by an anatomical predisposition, linked to increased mobility of the testicle within the scrotum. In these cases, the testicle may rotate more easily around its own axis.
It may occur during physical activity, at rest or during sleep. For parents, the most important thing is not to identify the cause, but to recognise the main symptom: sudden or worsening testicular pain.
When to book a consultation
In case of suspected testicular torsion, an urgent surgical assessment is needed.
It is important to contact a doctor or go to the emergency department quickly if a child or adolescent has acute testicular pain, worsening pain, nausea or worsening general condition.
The message to convey clearly is: do not wait and do not observe significant testicular pain at home.
Assessment and diagnosis
Diagnosis is based first of all on an urgent surgical examination, with assessment of the symptoms, the scrotum and the position of the testicle.
When possible and without delaying treatment, a testicular ultrasound scan may be performed. This can help assess blood flow to the testicle and provide further information about the clinical picture.
When there is strong clinical suspicion, the priority remains timely assessment and treatment.
How it is treated
Testicular torsion is not a condition to be treated with medication or observation.
When the suspicion is confirmed, treatment is urgent and surgical.
The aim is to explore the scrotum, assess the condition of the testicle, correct the torsion and reduce the risk of the episode recurring.
When surgery is needed and what it involves
Treatment consists of urgent surgical exploration of the scrotum.
During surgery, the surgeon assesses the testicle, corrects the torsion when possible and performs bilateral orchidopexy, meaning fixation of both testicles. This is because the opposite testicle may also have a predisposition to torsion.
The possibility of preserving the testicle also depends on how much time has passed since the onset of symptoms and on the degree of suffering of the testicular tissue.
Recovery and useful instructions
After surgery, hospital admission may last approximately 12–24 hours, unless otherwise clinically indicated.
The pathway generally includes:
Recovery depends on the condition of the testicle at the time of surgery and on the post-operative course.
Parents’ most common questions
Yes. Sudden, severe or worsening testicular pain should always be assessed quickly, especially if associated with nausea or worsening general condition.
Because it can reduce or interrupt blood flow to the testicle. If treatment does not take place within an appropriate timeframe, ischaemic damage may occur, with possible loss of the testicle.
An ultrasound scan may be useful, but it must not delay urgent surgical assessment when clinical suspicion is strong.
They should take the child or adolescent rapidly for urgent medical assessment, ideally to the emergency department or to a service able to manage a surgical emergency.
Sometimes episodes of pain may ease spontaneously, but this does not rule out intermittent torsion or another problem that deserves assessment. Even if the pain improves, it is advisable to speak to a doctor.
Note: the information on this website is provided for guidance only and does not replace a specialist medical assessment. In case of acute symptoms, significant pain or a worsening general condition, you should contact a doctor or go to the emergency department.
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