Testicular Pain and Torsion: teenage boys beware

Males have two oval-shaped structures called testicles which are located inside a thick-skinned sac called the scrotum. Each testicle is supplied with oxygen by an intertwined structure of muscle fibre, nerves and blood vessels called a spermatic cord. When this cord becomes twisted, it cuts off the blood supply to the attached testicle. This condition is called testicular torsion.

It causes sudden severe pain in the scrotum and testicle. Generally, the pain is quite persistent but may also come and go. Other symptoms that may be noted are nausea, vomiting, swelling on the scrotum, and having one testicle displaced higher than the other.

It can happen in males of all ages but is common between 12-18 years old. It can occur after strenuous exercise, while asleep or after a sports injury.

If your son feels pain in his testicles, bring him to the doctor as soon as possible.

The doctor will usually suspect torsion by physical examination alone but sometimes ultrasound may be done to confirm it. Immediate surgery to untwist the cord is warranted to save the testicle but if it caused too much damage already, the testicle is removed. Take note that there is more than 90 per cent chance of saving the testicle when treatment is given within six hours from the start of pain and only less than 10 per cent chance if more than 24 hours have elapsed.

Fortunately, even after removal of one testicle, the remaining testicle can still produce sperm and testosterone needed for fertility. However in some rare cases, the risk of infertility can be increased.

Sometimes, it can be awkward and embarrassing for your teenage son to talk about his genitals. Your son should be aware that any pain in his genitals should not be disregarded and should always be treated as a medical emergency.  

by Dr. Cynthia Dacanay, Family Medical Practice Hanoi