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Testicular torsion is a time-critical surgical emergency. If blood flow is not restored within four to six hours, the risk of losing the testicle increases significantly.
Medical negligence claims surrounding testicular torsion typically arise when medical professionals fail to diagnose the condition or provide treatment within the critical timeframe.
What is testicular torsion?
Testicular torsion occurs when a testicle twists inside the scrotum. This twisting cuts off the blood supply to the testicle and surrounding tissue.
Without blood flow, the testicle can become permanently damaged within hours.
Testicular torsion can happen after an injury or during exercise, but it can also occur when you are not doing anything strenuous, such as during sleep.
Testicular torsion can happen at any age. While it is most common in teenagers between the ages of 12 and 18, it can also affect newborns, children and adults.
What are the signs and symptoms of testicular torsion?
If you are suffering with testicular torsion, you will likely suffer with at least one of the following symptoms:
- Sudden, severe pain in one testicle
- Swelling of the scrotum
- Abdominal pain, nausea, or vomiting
- A testicle that sits higher than normal or at an unusual angle
- Redness or tenderness of the scrotum
What should you do if you suspect you may have testicular torsion?
These symptoms require urgent medical attention and you should attend your nearest A&E department as soon as possible. Do not wait to see if the pain improves.
Young people may feel embarrassed discussing intimate health concerns, however, it is very important to attend hospital immediately if any of the symptoms listed above occur.
How is testicular torsion diagnosed and how is it treated?
When you arrive at hospital, a doctor will assess the testicles, groin, and abdomen to look for classic physical signs of torsion.
If the physical exam is unclear, or to rule out other issues like infections, a doctor may order specific tests such as:
- Scrotal Ultrasound (with Doppler): This is the most common imaging test used to visualize the testicle and measure blood flow. Reduced or absent blood flow strongly indicates torsion.
- Urine and Blood Tests: These are done to check for urinary tract or bacterial infections to determine if the pain is caused by epididymitis instead of torsion.
If a physical examination strongly suggests testicular torsion, exploration surgery is often performed immediately without waiting for imaging tests.
Testicular torsion is treated with emergency surgery called orchidopexy. During surgery the testicle is untwisted, blood supply is restored and both testicles are secured to try and prevent torsion happening again.
If the testicle cannot be saved, it will need to be removed.
What is the potential impact of a delay in diagnosis of testicular torsion?
Testicular torsion cuts off blood supply to the testicle. The longer the delay in treatment, the greater the risk of permanent damage.
Typical outcomes depend on how quickly treatment is provided:
- Within six hours: High chance of saving the testicle
- After 12 hours: Risk of permanent damage increases significantly
- After 24 hours: The testicle will usually need to be removed
If the testicle dies and has to be removed, this will affect the appearance of the scrotum and can impact sperm count and fertility.
If you feel that you or a loved one has suffered serious harm as a result of a delay in diagnosis or treatment, please reach out to our Clinical Negligence Department who will be able to assist.
Lanyon Bowdler Solicitors settled a claim arising out of a delay in diagnosis and treatment of testicular torsion at The Shrewsbury and Telford Hospital NHS Trust in 2022. The case study can be read here: £42,000 in Compensation Following Delay in Diagnosis of Testicular Torsion
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