if you've had a sudden pain in your testicles or one of them feels like it's twisted around then you might have had something called a testicular torsion this is considered to be a Urological emergency and in this video we're going to cover the following items all of which are time stamped and split into sections so first of all what is a testicular torsion well testicular torsion occurs when a testicle rotates twisting the spermatic cord that brings blood to the scrotum this reduced blood flow causes sudden and often severe pain and swelling it's most common between 12 and 18 years of age but it can occur in any age even before birth and it can run in families now it's so important that you're seen as quickly as possible if you have this because it requires emergency surgery if it's treated quickly the testicle can usually be saved but when blood flow has been cut off for too long a testicle might become so badly damaged that it has to be removed and this obviously has important implications in terms of fertility so what are the symptoms of a testicular torsion but when someone has a torsion they often mention they've experienced sudden severe pain in the scrotum which is the loose bag of skin under your penis that contains the testicles they may also have a swelling of the scrotum pain in the tummy feeling sick and even potentially vomiting and potentially a fever when the doctor examines the testicles they might find that one of the testicles is positioned higher than normal or at an unusual Angle now young boys who've got testicular torsion typically wake up due to scrotal pain in the middle of the night or early in the morning now if this has happened to you or a family member then it is imperative that they seek Emergency Care straight away prompt treatment can prevent severe damage or loss of the testicle if torsion has occurred now even if you've had a sudden testicle pain or the sensation the testicle is rotated and then gone back that goes away without treatment you still need to seek medical attention because sometimes the testicle can twist and then untwist on its own and surgery is commonly needed to prevent this from happening again so now we know what a torsion is some of the symptoms and that it's classed as an emergency well what are some of the potential causes well testicular torsion occurs when the testicle rotate on the spermatic cord as I've already mentioned and that's the vessel that brings blood into the testicle from the abdomen if the testicle rotate several times then blood flow can be entirely blocked causing the damage more quickly it's not fully clear why testicular torsion occurs but most people who do get it usually have an inherited trait that allows the testicle to rotate freely inside the scrotum this inherited condition often affects both testicles but not every male with the trait will have a testicular torsion the torsion can also occur several hours after vigorous activity after a minor injury to the testicle or while sleeping cold temperature or rapid growth of the testicle during puberty may also play a role so what happens when you go to see your doctor about this problem well your doctor will ask you questions to verify whether your signs and symptoms have been caused by a testicular torsion or potentially something else doctors often diagnose testicular torsion with a physical exam of the scrotum testicles abdomen and groin they may also test your reflexes by lightly rubbing or pinching the inside of your thigh on the affected side normally this causes the testicle to contract and move upwards but this reflex might not occur if you've had a torsion ultimately if you have had a torsion then you're going to need emergency surgery to save the testicle for this operation you'll be put asleep a cut or incision is made in the scrotum the testicle is then examined untwisted and the testicle observed for return of blood supply now to prevent the torsion happening again the testicle is going to be fixed in place with stitches and to prevent torsion on the opposite side the other testicle will also be fixed in position the cuts are then closed with stitches that dissolve so they don't need to be removed later now if a Twist is not found the testicle will still be examined to look for other causes of your symptoms such as infection if the testicle hasn't survived it will be removed surgery of course comes with risks and benefits and the British Association of urological surgeons has put together a great list of potential complications and information about surgery and I've included a link to this in the description box now some of these potential complications or risks include infection in the wound collection of blood around the testicle which is called a hematoma unfortunately loss of the testicle in the future even though it was hoped the testicle had been saved as well as long-term scrotal pain finally let's just go over some top tips for recovery after the operation here in the UK the stitches that are used are dissolvable so these don't need to be removed you might have some discomfort for a few days and in this case you should take regular painkillers so things like paracetamol for at least two days and for a few days longer if you need to you should also wear supportive brief style pants rather than loose fitting boxes for two weeks so these can increase comfort you may have been given underwear called a scrotal support which are medical grade supportive pants and these can be swapped to normal normal cotton pans if you prefer and they're more comfortable after a few days you should make sure that you rest for a few days at home and you take a week off school college or work you should also avoid swimming for seven to ten days and avoid strenuous activities for example physical exercise riding a bike for at least three to four weeks the wound site should be kept clean and dry and it's fine to take showers after two days but you should avoid taking baths for five days finally if you feel unwell you've got a fever you've noticed increased pain or noticed discharge at the wound site you need to let the medical team know as soon as possible because this could be the sign of an infection finally all boys and men regardless at what age should regularly check their testicles every month to make sure that they can't feel any lumps or bumps if you do notice any lumps bumps or your testicles don't feel the same as normal make sure you speak to your doctor