Testicular pain is always an emergency
Luise Heine has been an editor at since 2012. The qualified biologist studied in Regensburg and Brisbane (Australia) and gained experience as a journalist in television, in the Ratgeber-Verlag and in a print magazine. In addition to her work at , she also writes for children, for example for the Stuttgarter Kinderzeitung, and has her own breakfast blog, “Kuchen zum Frühstück”.
More posts by Luise Heine All content is checked by medical journalists.There is hardly a place on the male body where pain is more uncomfortable than in the testicles. And acute and severe complaints from these small hormone and seed factories should always be taken seriously. In adolescents in particular, twisting of the testicles on the spermatic cord, a so-called testicular torsion, is the cause of pain in one out of five cases. And it has to be dealt with quickly. This is now also underlined by a new medical treatment guideline.
By twisting the testicles and epididymis, their blood supply is squeezed off. Severe pain, swelling and reddening of the testicles are the alarm signals that should immediately lead those affected to a urologist or a urological emergency room.
Dangerous circulatory disorder
Because after just six to eight hours, testicular tissue that is no longer supplied with blood would die. Damage that cannot be reversed. But young people in particular often hesitate to go to the doctor out of shame. "This can mean that the twist has been there for hours when we see the patient," explains the pediatric surgeon Prof. Christian Lorenz, who coordinated the creation of the new guideline "Acute Scrotum". The chance of preserving the testicle is then poor, even with an emergency operation.
Acute testicular pain is always an urgent emergency, emphasizes the German Society for Pediatric Surgery (DGKCH). Only the doctor can use special devices to determine whether the symptoms are actually caused by testicular torsion and how severe the circulatory disorder is. At the same time, other, similarly painful diseases such as testicular inflammation or testicular cancer can be tracked down.
Testicular fixation by surgery
If the examination reveals that the testicle is actually not supplied with enough blood, an operation is carried out immediately. To do this, the corresponding scrotum compartment is opened, the twist is canceled and the testicle is fixed with a seam inside the scrotum. The new guideline recommends using the procedure on the other testicle as a preventive measure, as the risk of torsion is often bilateral.
With timely surgery, the loss of the testicle can usually be prevented. "The testicle only needs to be removed if it is irreparably damaged," says Professor Bernd Tillig, President of the DGKCH. This reduces fertility because the sperm density in the ejaculate decreases.
Cosmetic impairments, on the other hand, can easily be compensated for: When the body has finished growing, the missing testicle is replaced by an implant made of soft plastic. Not only does this look like a testicle, it feels similar too.
Bad attachment
Testicular torsion can occur at any age, but there are two “age peaks”. For babies under one year old and for boys aged 12 to 18 years. For them, the probability of such an incident is 1 in 4000, which means: One in 4,000 boys in this age group suffers a twisted testicle.
Possible causes are an undescended testicle, in which the testicle is not down in the scrotum, and a hypermobile testicle. Then the gland can twist and strangle itself during everyday movements or normal sporting activity. Testicular torsion can even occur when moving during sleep.
Source: Press release German Society for Pediatric Surgery e.V.
