Treatment
The treatment of testicular torsion should be carried out as soon as possible, because if the blood supply to the testis is not guaranteed, there is a risk that tissue will die off and the function of the testis will ultimately be lost.Until the testicle dies completely, the treating physicians have about four to six hours to restore the supply. Depending on the severity of the testicular torsion, the torsion can also be released without surgery. In this case the attending physician, usually a urologist, attempts to untwist the spermatic cord by means of specific grips.
The position of the testicle can then be checked by means of ultrasound. In most cases, this manual therapy is the first treatment in an acute emergency situation. However, since it is not always possible to be sure whether the re-torsion was successful, surgery is usually preferred.
In addition, the testicle can be fixed with small sutures to avoid further torsion of the testicle. Sudden pain in the testicle and groin area may indicate a torsion of the testicle, especially if physical activity or cycling preceded the pain. The patient should then consult a doctor.
Since any touch can aggravate the pain, the patient should also refrain from any permanent manipulation of the testicles. This includes cooling the testicles or wearing tight pants. It is best to consult a doctor as soon as possible who can quickly find the cause.
During the surgical treatment, the scrotum itself is opened or access to the testicle is through the inguinal canal. At first the testicle is dissected to get an exact overview and to determine the direction of the twisting. After the testicle has been returned to its original position, we wait to see if the blood supply is secured again.
In addition, the doctors observe whether the testicle tends to twist again. In order to prevent a recurrence of the torsion, the testicle is sutured in the scrotum with small stitches. This significantly reduces the risk of twisting.
This measure is called orchidopexy. Often this is also done on the opposite side, because there is also the risk of the testicle twisting at some point. If the tissue is already partially damaged, an attempt is made to remove the damaged tissue.
It is hoped that the testicle still has a residual function and is still able to produce sperm cells. If the blood supply to the testicle does not start up again during the operation, the tissue is too badly damaged and already dead. This testicle will then be removed because it can no longer perform its function.
