For unknown reasons, a testis, the male sex gland, may become twisted, shutting off the blood supply. Although the condition is more apt to affect boys who have an undescended testis, it is quite common among boys whose testes are in the normal position in the scrotum, the pouch of skin behind the penis. The condition may also follow a minor injury.

Signs and symptoms

A testis that is twisted first becomes slightly swollen and tender. Within a few hours it is intensely painful, and very tender and swollen. The testis and the surrounding skin become discolored (red or blue), and the boy may be nauseated or vomit and have lower abdominal pain and a fever.

Torsion (twisting) of a testis that has descended into the scrotum may be confused with an infection (orchitis), a strangulated hernia, or a bruise of the scrotum. Torsion of a testis that has not descended and lies in the groin may be confused with a strangulated hernia, an injury, or infected lymph glands in the groin. Torsion of an undescended testis that lies within the abdominal cavity is difficult to diagnose but may be suspected whenever abdominal pain occurs. This is an emergency situation and requires immediate medical treatment.

Torsion of a part of a testis (appendix of the testis) causes similar, although less intense, symptoms. Nevertheless, this too is considered an emergency. Both conditions are treated the same way.

Home care

Do not attempt home treatment. Torsion  of the testis is an emergency that requires G immediate surgical correction.

• Take your child to a doctor immediately if pain near testis increases and the testis is tender, swollen, or discolored. Do not delay; hours count.

• Suspect torsion of the testis in a boy with an uncorrected, undescended testis if he has lower abdominal pain or pain in the groin.

• An injury or a bruise of the scrotum and testis is not uncommon and will cause instant pain that gradually subsides. If pain increases following an injury or a bruise, suspect torsion of the testis.

Medical treatment

Your doctor will arrange immediate surgery to untwist the testis and to anchor it in the scrotum in order to prevent further episodes. If surgery is not performed within 24 hours of the onset of symptoms the testis may be damaged permanently.


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