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Each testicle is enclosed in a fibrous, double-layered sheath
within the scrotum, which itself is a simple pouch-like
structure composed of skin and muscle. The sheathed testicle is
attached to the spermatic cord in a manner that prevents it from
twisting out of its natural position. In some males, however,
the sheath is abnormally loose, and as a result, the testicle
may become twisted.
When an abnormal twisting of the testicle and spermatic cord
occurs, restricting the blood supply, it is known as testicular
torsion. An extreme twist (torsion) can happen at any time, even
when the sufferer is asleep. Therefore prompt treatment is
required to prevent permanent damage - if the oxygen supply is
restricted for too long a period, gangrene may set in, requiring
surgical removal of the testicle. Testicular torsion may also be
responsible for infertility.
Cause and Incidence
Testicular torsion occurs most often in young men between the
ages of 12 and 20, although it can occur at any age, even in
infancy. Testicular torsion is very rare - only 1 in 5000 males
is likely to consult a doctor with this condition in an average
year. Unfortunately, little can be done to prevent it as it
often occurs for no apparent reason. Although physical exertion
does seem to be a major cause.
Symptoms:
The patient may experience a sudden acute pain in the
testicle, although gradual onset of pain maybe found in up to
25% of cases. The affected testicle is usually swollen, painful
and tender. The pain varies, however it can be so severe, that
you feel nauseated. You may also have a fever and feel somewhat
light-headed. There is a possibility that the condition resolves
itself, affording you the much needed relief.
Treatment:
Prompt treatment is vital in preventing permanent damage or the
loss of the testicle, so see your doctor at once - even if it
means visiting an emergency room at 3am in the morning! Even if
the twist seems to have cured itself it is still necessary to
consult your doctor without delay. If the testicle has not
returned to its normal position, your doctor may try to 'undo'
the twist by gently manipulating the testicle. Even if this
proves successful, the problem usually recurs. Surgery is always
necessary, usually within hours of the attack, whereby complete
untwisting of the organ can be performed, and if necessary the
surgeon will stitch the testicle into a position that will
prevent reoccurrence. Occasionally, removal of the affected
testicle may be necessary.
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