Torsion of testicles (twisted balls)

What is torsion of testicles?

This is where the testicle (ball) twists on the cord it hangs on, like a conker on a string. The cord contains the blood supply and if it twists it causes the blood supply to stop. If the testicle is without blood supply for 6 hours it is severely affected and may not recover.

It is a surgical emergency. Which means we need to get you to theatre quickly to untwist it. This happens with an operation with you fully asleep. The surgeon will untwist it and fix it to stop it happening again. We will also fix the non-twisted side to prevent the same thing happening on the other side.

Why are we telling you about this condition?

We need to take you for an operation because you have a painful testicle which might be torsion of testicle. It might also be something else like a cyst or an infection. Unfortunately, we do not have a good test to tell us. Sometimes ultrasound can be useful but more often it will not help. Your doctor will talk you through this if it might help.

What should I expect?

Once we have decided to take you to theatre the surgeons will go away and try and find a space in theatres. Sometimes this takes a bit of juggling things around. Rest assured we are trying our very best to get you in quickly, but sometimes it can be difficult.

You will go down to the anaesthetic room and go to sleep. We will make a cut in the scrotum (the sac around your testicles) have a look and untwist the testicle if needed, and fix it like we described above. If we find the testicle is badly damaged and we are certain it will not survive we take it away. The reason we do this is that a badly damaged testicle if left, would be sore and can get infected.

You will wake up about an hour later. You should not be too sore and we give pain killers and local anaesthetic (numbing injection).

What are the risks?

The major risk of the condition is losing the testicle which is almost guaranteed if it takes over 24 hours, from when it starts, to get to theatre.

If less than 6 hours, we can normally save it. In between, we do not always know. So we will speak to you a year after you go to theatre to check there has been no late problems.

Other risks of the surgery include the general anaesthetic, wound problems, pain and infection.

What happens if my testicle does not survive?

The good news is you can live a normal life with 1 testicle. It wont affect your ability to have children or grow into a man. You would have to look after your single testicle though. If you are worried about how it looks, we can give you a fake testicle when you have finished going through puberty.

What is the aftercare?

You will be a bit sore for 3 to 5 days, so take it easy and take regular paracetamol (4 times a day) and ibuprofen (3 times a day).

You will see stitches and these will take about 2 weeks to dissolve away.

Your doctor will tell you about baths or showers. It is best not to bath or swim for 2 to 3 days, but a quick shower will be fine.

You can get back to normal activities as you feel able. We normally advise move about as much as you can and return to exercise once the stitches have fallen out and you are not too sore.

If you have torsion, we will make an appointment to catch up with you about a year after the problem to see everything is okay as you go through puberty.

What if I have more questions?

Talk to the doctors or nurses involved in you care. There are no silly questions!