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Testicular Torsion in children: When Every Minute Matters – Dr Prabhu Karunakaran, consultant Pediatric Urologist.

January 13, 2026 Uncategorized by blogcreater

Testicular pain is never something to ignore—especially when it comes on suddenly. One condition, in particular, demands immediate attention: Testicular Torsion. Understanding what it is, how it happens, and when to act can make a critical difference.

What Is Testicular Torsion?

Testicular torsion occurs when the spermatic cord, which supplies blood to the testicle, twists unexpectedly. This twist cuts off blood flow almost instantly. The result is sudden, intense pain, rapid swelling, and often a sense that “something is very wrong.”

This is not a condition that improves with rest or medication. Testicular torsion is a true surgical emergency. Without prompt treatment, the testicle can suffer permanent damage, and delayed care may lead to its removal.

While torsion can occur at any age—even in newborns—it is seen most often in boys and young men between 10 and 25 years, particularly around puberty.

Why Does Testicular Torsion Happen?

Inside the scrotum, each testicle is normally anchored in place while hanging from the spermatic cord. In many boys with testicular torsion, this natural attachment is missing due to a congenital condition called the bell-clapper deformity. When this support is absent, the testicle can rotate freely—making a sudden twist much more likely. Torsion can occur:

During or after physical activity
While sleeping
After a direct injury to the scrotum

In many cases, however, there is no clear trigger. It can happen without warning.

Recognizing the Symptoms

Testicular torsion usually announces itself clearly—and urgently. Seek immediate medical care if your child experiences:

Sudden, severe pain in one testicle or the groin
Rapid swelling on one side of the scrotum
Nausea or vomiting
Lower abdominal pain
A testicle that appears higher than normal or tilted at an unusual angle

The pain may rise and fall but rarely disappears completely. This is not something to “wait and see.” If torsion is suspected, time is critical.

How Is Testicular Torsion Diagnosed?

A pediatric urologist begins with a focused physical examination. In many cases, an ultrasound with Doppler imaging is used to check blood flow to the testicle. Blood and urine tests may help rule out infection when the diagnosis is uncertain. However, when the clinical signs strongly point to torsion, the doctor may proceed directly to emergency surgery. Delaying treatment for additional tests can risk permanent damage. Why the urgency?

Within 6 hours: up to 90% chance of saving the testicle
After 12 hours: chance drops to about 50%
After 24 hours: chance falls to roughly 10%

How Is Testicular Torsion Treated?

The definitive treatment for testicular torsion is urgent surgery. In rare situations, a doctor may temporarily untwist the testicle manually, but this is not a final solution. Surgery is still required to prevent recurrence. During the procedure:

Your child is placed under general anesthesia
A small incision is made in the scrotum
The spermatic cord is untwisted to restore blood flow
Both testicles are secured to the scrotal wall (orchidopexy) to prevent future torsion

After surgery, your child will need to avoid sports, running, and strenuous activity for several weeks. Your doctor will guide a safe and gradual return to normal routines. If blood flow cannot be restored because the torsion lasted too long, the affected testicle may not survive and must be removed (orchiectomy). The good news is that most boys with one healthy testicle still have normal hormone levels, normal puberty, and normal fertility. Some choose to have a prosthetic testicle placed later for cosmetic comfort. In newborns, torsion can be more difficult to diagnose, and the timing of the twist is often unclear. Early evaluation by a pediatric urologist is essential.

Key Takeaways:

Sudden testicular or groin pain is never normal.
Acting quickly can mean the difference between saving and losing a testicle.
When it comes to testicular torsion, minutes truly matter.
If your child complains of sudden scrotal pain, do not wait. Consult a trained Pediatric Urologist

Book a Consultation

For expert pediatric urology care and robotic surgery in Hyderabad:

Visit: https://drprabhukarunakaran.com/appointment/
WhatsApp: 8500550328 or Call: 8500550328

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