Testicular torsion: symptoms, first aid and treatment in Tashkent

Other names: Заворот яичка, перекрут семенного канатика, острая мошонка

Testicular torsion is a condition in which the spermatic cord twists around its axis and completely cuts off the blood supply to the organ. This is one of the few situations in urology where time is measured literally in hours: without restoration of blood flow, the testicle dies. Most often, torsion occurs in adolescents, often at night or after physical activity, and the main mistake is trying to “endure it until the morning.”

🧾 МКБ-10: N44 🏥 Where it is treated: 2 The clock is countingMore often in teenagersCan't wait until morning

👨‍⚕️ Which doctor

Urologist, pediatric surgeon

🔬 Diagnostics

Examination, ultrasound of the scrotum with Doppler

💊 Treatment

Emergency surgery

📈 Prognosis

Depends on time before surgery

⚠️ At risk

Adolescence, fixation abnormality

⏱ When to see a doctor

Immediately, call an ambulance

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Внезапная резкая боль в яичке, возникшая за считанные минуты
Боль с тошнотой и рвотой
Яичко подтянуто вверх и расположено горизонтально
Отёк и покраснение половины мошонки
Боль, разбудившая ночью
Любая острая боль в мошонке у мальчика или подростка

What happens during torsion

The testicle is suspended on the spermatic cord, inside which there are an artery, veins and the vas deferens. Normally, the membranes fix the testicle and prevent it from rotating freely.

With a congenital feature of fixation - the so-called “bell tongue” type anomaly - the testicle is mobile and can rotate around the cord. The vessels are pinched: first the veins are blocked, swelling increases, then the arterial inflow stops. Testicular tissue begins to die.

The rate of tissue death depends on the degree of torsion. With a full turn, the changes become irreversible already in the first hours, so the only correct tactic is immediate treatment, and not observation.

Symptoms

Sudden severe pain in one side of the scrotum that occurs within minutes
The pain often begins at night or after exercise or a sports injury, sometimes for no reason
Nausea and vomiting are a very common companion
Swelling, redness, or blueness of half the scrotum
The testicle is pulled upward, located higher than usual and often horizontally
Sharp pain when touched
Body temperature is usually normal in the first hours
Urination is usually not impaired
Sometimes - episodes of similar pain in the past that passed on their own

Отдельно о повторяющихся кратковременных приступах боли в яичке, которые проходят сами: это может быть перемежающийся перекрут с самостоятельным раскручиванием. Такая ситуация — показание к плановой операции фиксации яичек, потому что следующий эпизод может завершиться иначе.

How to distinguish from inflammation

Torsion: sudden onset, within minutes; often teenagers; nausea and vomiting; temperature is normal; the testicle is pulled up; urination is not impaired
Epididymitis: gradual onset, over hours or days; more often adult men; often temperature; pain is greater in the appendage; there is often pain when urinating or discharge
Hydatid torsion: moderate pain, local, sometimes a bluish dot appears through the skin; general condition suffers little
Injury: Clearly related to impact

However, clinical signs are not enough: the picture is often blurred. The decisive factor is an ultrasound of the scrotum with Doppler sonography, showing the presence or absence of blood flow in the testicle. If doubts persist, surgical revision is performed - because the cost of error is too high.

What to do immediately

Вызвать скорую помощь или самостоятельно доставить человека в clinicsу с круглосуточной урологической службой
Не принимать обезболивающие в надежде переждать: снятие боли не восстанавливает кровоток и лишь затягивает обращение
Не прикладывать тепло
Не пытаться самостоятельно раскрутить яичко
Не есть и не пить — вероятна операция под наркозом
Запомнить точное время начала боли: это важнейшая информация для хирурга

Treatment

Emergency surgery - revision of the scrotum: the testicle is untwisted, its viability is assessed
Orchiopexy - fixation of the testicle with sutures to prevent re-torsion
Mandatory preventive fixation of the second testicle: anatomical feature, usually bilateral
Removal of a testicle with obvious necrosis - if the tissue has already died, its preservation is dangerous and can damage the second testicle due to immune mechanisms
Manual untwisting is possible as a temporary measure before surgery, but does not cancel it
Installation of a testicular prosthesis if desired by the patient - discussed on a delayed basis
Pain management and observation in the postoperative period

Даже если яичко удалось спасти, фиксация обоих яичек выполняется обязательно. Особенность строения оболочек, приводящая к перекруту, почти всегда имеется с обеих сторон, и без фиксации риск перекрута второго яичка остаётся высоким.

Forecast and consequences

The determining factor is the time from the onset of pain to the restoration of blood flow
With help in the first hours, the probability of saving the testicle is high
With every hour of delay the chances decrease
After prolonged ischemia, the testicle may atrophy even if
The loss of one testicle usually does not affect hormonal levels and fertility if the second one is healthy
There may be a slight deterioration in sperm count after torsion.
The psychological aspect and the issue of prosthetics are discussed individually

Where to contact in Tashkent

In case of acute pain in the scrotum, an urgent examination by a urologist, ultrasound with Doppler sonography and readiness to operate immediately are necessary.

In Tashkent, such care is provided at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.

Parents of teenagers: Any sudden pain in the scrotum should be considered torsion until a doctor proves otherwise. Constriction and waiting until morning is the main reason for testicular loss in this condition. Clinic contacts are below.

Services and prices for this diagnosis

Based on official price lists of Tashkent clinics. The exact cost is determined after examination.

🔬 Diagnostics

Первичный приём урологаfrom 200 000 Повторный приём урологаfrom 150 000

💊 Treatment

Орхипексия с одной стороныfrom 5 750 000

Frequently asked questions: Testicular torsion

How much time do you have to save a testicle?+

The clock is ticking, and the sooner blood flow is restored, the higher the chances. In the first few hours, the probability of saving the organ is high, then it quickly decreases. That is why, if there is sudden pain in the scrotum, you should contact it immediately, without waiting for the morning and without trying to wait it out with painkillers.

Can torsion go away on its own?+

Sometimes the testicle untwists on its own and the pain subsides - this is called intermittent torsion. But the relief is deceptive: the anatomical feature is preserved, and the next episode may end in complete torsion with the death of the organ. Therefore, after such attacks, planned fixation of both testicles is recommended.

Why is a healthy testicle also fixed?+

Because the structural feature of the membranes, due to which the testicle can rotate, is usually present on both sides. If only the victim is recorded, the risk of torsion of the second testicle remains significant. Prophylactic fixation is performed during the same operation and does not prolong recovery.

How to distinguish torsion from inflammation yourself?+

It’s not reliable, and it’s not worth trying. Approximately, torsion is characterized by a sudden onset within minutes, nausea, normal temperature and high position of the testicle, while epididymitis increases gradually, often with fever and difficulty urinating. But the picture can be blurry, so the diagnosis is made by ultrasound with Doppler sonography, and if in doubt, surgery is performed.

What happens if the testicle is removed?+

With a healthy second testicle, hormonal levels and the ability to have children are usually preserved: the remaining organ compensates for the function. There may be a slight deterioration in the sperm count, so when planning a pregnancy it is worth taking it. If the patient wishes, installation of a testicular prosthesis for cosmetic results is discussed.

Does torsion occur in adult men?+

It does happen, although much less frequently: the peak occurs in adolescence and the first year of life. In adults, acute pain in the scrotum is often associated with epididymitis, but torsion must be excluded at any age, since the consequences of the error are the same.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.

Where it is treated testicular torsion в Ташкенте

При подозрении на перекрут нужна clinic, где круглосуточно доступны УЗИ с допплерографией и экстренная операционная. В Ташкенте такую помощь оказывают в медицинском центре UROLOGIC COMPLEX и в clinicsе Tashkent Medical Park.