Dr Varinder Attri – Urologist, Andrologist and Laparoscopic surgeon

Scrotum is the skin pouch which holds the testis within it. Pain in scrotum is relatively common condition in men which can be a result of testicular infection, epididymis infection, testicular cord infection, torsion of testis etc. Infection of the testis and epididymis are common causes of painful scrotum; being more common in adult men and are insidiousin onset and progression. But the acute emergent condition requiring urgent attention is torsion of testis. It is more common in children. We will look into this condition  briefly in subsequent text.

What is testicular torsion ?

Testicular torsion is the condition where the cord supplying the blood vessels to testis get twisted, hence impairing the arterial blood inflow to the testis and leading to it’s damage. It present with sudden pain in scrotum and often associated with vomiting. If neglected for more than 6 hours, it can lead to permanent damage to testis.

What are the symptoms of testis torsion ?

Patient with testicular torsion present with sudden onset pain in the scrotum, often associated with nausea and vomiting.  It lead to the swelling of the scrotum.

How to diagnose this condition?

Testicular torsion is suspected by the peculiar history of its sudden onset in  young children. A clinician often make the diagnosis by carefully examining the involved testis. Colour doppler ultrasound gives the definitive diagnosis by showing the absence of blood flow into the involved testis. Sometimes, doctor advice urgent surgery merely going through the history and examination.

What is the treatment for testicular torsion ?

Torsion testis is a surgical emergency needing its urgent correction. Patient requires surgery so as to do de-torsion (relieving the rotation of the cord containing blood vessels) of the testis. This de-torsion re-establish the blood flow of the testis and making it work again. Failing to do this will lead to permanent damage of the testis, rendering it non salvageable. This correction should be done within 4-6 hours of torsion episode.

Whom to consult for acute painful episode in scrotum?

Urologist or/and Andrologist are the doctors who look after the conditions pertaining to painful scrotum.

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