Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2013;88(12):online

See related article on testicular torsion.

What is testicular torsion?

Testicular torsion (tes-TICK-yoo-ler TOR-shun) happens when the testicle gets twisted within the scrotum. This decreases the flow of blood to the testicles. If it's not treated quickly, the testicle can die, or it can become damaged so that it doesn't work right.

Why does it happen?

The cause is usually not known. Some males have changes in their anatomy that make the testicles more likely to twist. There is no way to know for sure who will develop torsion.

Who gets testicular torsion?

Males of any age can get it, but it happens most often in newborns and teenagers.

What are the symptoms?

You may have pain and swelling in your testicles or scrotum. You may have a fever or nausea. One testicle may be higher and firmer than the other. You may have had recent trauma to the testicle, or woken up from sleep with these symptoms. Not everyone will have every symptom, and sometimes the symptoms will change depending on how much time has passed.

If I have symptoms, what should I do?

See your doctor as soon as possible. Testicular torsion is an emergency. If any of the symptoms develop, don't wait for them to improve. Sometimes, the pain and swelling go away because the testicle is dying. If your doctor can treat the torsion within 4 to 8 hours after the symptoms start, the testicle usually can be saved. If you wait longer, especially more than 24 hours, may lose the testicle.

Your doctor will do a physical exam. He or she may also order other tests, like a urine test or an ultrasound of the scrotum.

If you do have testicular torsion, you will need surgery right away. Do not eat or drink on the way to the doctor.

How is testicular torsion fixed?

You will need to have surgery to untwist the testicle. It is important to follow up with your doctor after surgery to see if the testicle is working normally.

Where can I find out more?

AAFP's Patient Education Resource

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