Torsion of the testicle refers to the rotation / twisting of the testicle around its longitudinal axis. When this happens, blood flow to the testicles is cut off, resulting in severe pain and swelling in the corresponding scrotal half. This condition requires immediate medical attention. If timely treatment is given, the testicle can usually be saved. But when the blood flow is interrupted for a long period of time, the damage can be irreversible and surgical removal of the testicle (orchiectomy) may be necessary. The most characteristic symptom is the onset of sudden severe pain on one side of the scrotum, which is accompanied by nausea and vomiting, abdominal pain and sometimes fever. Edema in the corresponding scrotal half and a change in skin color quickly form. Testicular torsion is an emergency. The affected testicle will decrease in size if blood supply is not restored within 6 hours. This will lead to tissue necrosis and gangrenous-phlegmonous inflammation of the corresponding scrotal half. The slow onset of pain, over hours or days, may be a sign of a sprain, but this is rare. Problems urinating, such as burning or frequent urination, are not typical signs of torsion. Most often, torsion is unilateral and the left testicle is typically affected. Only in 2 out of 100 men can it be seen bilaterally. Testicular torsion is uncommon. It affects about 1 in 4,000 men under the age of 25. Newborns and older men can also be affected. Physical activity is not a risk factor causing this pathology. This can happen during exercise, sitting, or even while sleeping. Testicular torsion is often diagnosed with a physical exam. X-rays can also be used to make the diagnosis. Ultrasound can check blood flow to the testicles. A sprain should be treated quickly. Permanent damage occurs after 6 hours. Studies have found that nearly 3 out of 4 patients require an orchiectomy if surgery is delayed 12 hours after the onset of damage. The testis is detorqued and then secured to the scrotum to prevent future torsion. Most often, the operation is done through the scrotum. If the testicle cannot be saved, the operator performs an orchiectomy of the affected testicle and fixes the healthy testicle to the scrotum to reverse any subsequent torsion. In most cases, when one testicle is removed, the opposite testicle increases in size to compensate. Regardless of whether the testicle is removed or not, recovery from surgery will take time. You may need to take painkillers for several days. Exercise and training should be avoided for several weeks after surgery. The stitches used to fix the testicle should not cause discomfort. A large number of men very often ask themselves the following questions.How will their fertility be affected after losing a testicle? The truth is that only one testicle is needed for normal fertility, production of normal amount of sperm and testosterone. But some studies show that after torsion, up to a third of patients have a lower sperm count. How will losing a testicle affect my lifestyle? If you have lost a testicle, you should be careful with the one that is “left”. It is necessary to wear protective equipment when practicing sports, if you have any discomfort in the scrotal area, seek medical attention immediately. With age, the amount of testosterone will decrease earlier compared to people who have not undergone orchiectomy, therefore, regular control of testosterone levels in the body is necessary. Should I Consider Prosthetic Testicular Implantation? A testicular prosthesis is used to restore appearance and feel. Most often, prostheses are placed in patients who have completed their sexual development. If a smaller prosthesis is used in a young boy, reoperation will be required at a later stage to fit an age-appropriate size. Usually, the operation to place a prosthesis is done a few months after the orchiectomy. Can a newborn have testicular torsion? Yes, although this is very rare. Its exact cause is unknown – it may be due to a difficult birth or occur during intrauterine development. Unfortunately, in most cases, the testicles cannot be saved.