What to do if testicular pain appears?

Sudden testicular pain is the main symptom of the so called acute scrotal syndrome. It’s a urologic emergency that includes diverse intrascrotal pathologies, such as testicular torsion, testicular appendices torsion (hydatid), orchitis, epididymitis and traumas.

The common denominator of all of them is the sudden testicular pain that can involve other symptoms depending on its etiology, such as swelling and reddening of the scrotum skin, nauseas, vomit or urinary discomfort. Each one of these symptoms helps to determine the diagnosis.

“If a sudden testicular pain appears, you have to go to the Emergency Room ASAP in order to establish an early diagnosis of a possible testicular torsion”, says Dr. Ferran Garcia, director of the Andrology Unit of Institut Marquès.

This problem –more common during pediatric age than adulthood– can cause a circulatory obstruction, reducing the arterial blood flow and causing irreversible lesions to the testicle if it goes over six hours, leading even to necrosis.

The diagnosis is not always easy as the swelling and the pain make the examination difficult. Therefore, surgical intervention is usually the only way to confirm and reverse the torsion of the testicle, fixing it to prevent recurrent torsion.

Up to 80% experience a reduction of spermatogenesis (i.e. production of spermatozoa): this percentage is related to the duration of the testicular torsion, which means that it could be the cause of infertility.

According to Dr. Ferran García, it’s necessary to follow-up annually with prepubertal children that have already had a torsion, to control possible testicular atrophy, which can occur up to the 60% of recovered testicles up to 2 or 3 years after torsion.