I was 14 years old when I woke up to the worst pain in my life. A few hours later, I was on my way to get emergency surgery to save my testicle.
I had testicular torsion, and though I’d heard of it, I wasn’t entirely familiar with what the signs were, what treatment entailed—or quite how painful it was.
I’m almost twice that age now, and it’s still the most painful thing I can remember.
Testicular torsion is fairly uncommon. According to the Cleveland Clinicexternal link, opens in a new tab, it affects about one in 4,000 people with testicles under the age of 25. But that’s still a lot of people, many of whom don’t know very much about the condition.
It’s a medical emergencyexternal link, opens in a new tab that can lead to the loss of the affected testicle without surgery, so it’s important to be aware of what to look out for. Knowing the symptoms could help you or someone else get the help you need in time.
I went through testicular torsion as a 14-year-old in the UK in 2013, so my experience isn’t going to be the same as everyone’s, although my firsthand experience might help you. I’m also sharing what clinicians and researchers know about the condition, the symptoms, and what to expect from surgery and recovery.
What is testicular torsion?
Testicular torsion happens when a testicle rotates and twists the spermatic cord, which brings blood to the scrotum. This causes pain and swelling that will grow more intense the longer bloodflow is obstructed or blocked. Eventually, the testicle can die because the cells are not getting enough oxygen and nutrients.
It occurs most frequently in teenagers, but it can happen at any age. One of the biggest risk factors is something called bell clapper deformity, which is when the testicle isn’t attached to the scrotum by the gubernaculum, a small cord of tissue, making it more susceptible to twisting.
Other potential risk factors can include a minor injury to the testicles, cold temperatures, family history, or rapid growth of the testicle during puberty. If you had testicular torsion in the past and did not treat it, that will also increase your risk of having it again. Testicular torsion is not caused by physical activity such as exercise or sex. It can happen any time, including while you’re asleep, like it did to me!
It’s not life-threatening, but it does require emergency treatment. If a surgeon doesn’t operate within about six hours of the initial symptoms, it may not be possible to save the testicle. And if a testicle dies and is left untreated for a long time, it could cause a blood infection, known as sepsis, or other serious complications, but that is exceedingly rare.
The priority is getting medical attention as soon as possible.
What are the symptoms?
The main symptoms are the following:
- Sudden and severe pain in the scrotum
- Swelling
- Abdominal pain
- Nausea and vomiting
- A testicle at an unusual angle or higher than normal
- Frequent urination
- Fever
If you experience any of these symptoms, you should get medical attention immediately, because every minute counts. If you’re not sure about whether you should go to the emergency room, urgent care, or a regular doctor’s office, many doctors’ offices, hospitals, and public health entities have advice nurses who can discuss your symptoms and recommend next steps.
Health care providers have seen it all and they’d rather you come in because you’re concerned about your health than see you hours or days late because you didn’t want to be a bother or felt shy about your symptoms.
Often, young people who have testicular torsion wake up with pain in the middle of the night or early in the morning, and that’s what happened to me.
I woke up on a Sunday morning with unbearable pain and spent most of my time alternating between throwing up in the bathroom and lying on all fours on my bedroom floor. My parents weren’t sure what was going on and thought at first that I was being overdramatic.
I don’t hold it against them. I did have a tendency to be overdramatic at times, and testicular torsion probably isn’t the first thing parents would think of in that situation, but they could tell I was serious.
I’d had testicle pain and discomfort now and again in the past, usually upon waking up, which I put down to puberty. But I knew whatever was going on on this occasion was different. I was vaguely aware of testicular torsion and it was something that came into my head.
It was embarrassing to be so frank with my parents, if I’m being honest. I was 14, and pretty much everything felt embarrassing for me at that age, let alone approaching my parents to discuss my genitals. But the pain was so intense that my desperation overrode any feelings of embarrassment or awkwardness.
And, because testicular pain and discomfort are somewhat common during puberty, it’s important to differentiate the two. One is manageable, if uncomfortable. The other is something else. The pain was so intense I struggled to walk or even stand up straight, and could barely think coherently.
One of the reasons I wanted to write this is because I had heard of testicular torsion before. Not in depth, but just enough that it flashed in my head while I was lying in agony. I sometimes ask myself whether being aware of what it could be helped my parents take it more seriously, and whether knowing it was something to be concerned about it was what ultimately saved my testicle.
If you don’t quite know how to bring it up to your parents, or whoever you live with, you could say something along the lines of, “It hurts down there and it’s not normal.” Be clear about the intensity of the pain and how it’s affecting your ability to function, like it did to me. I’ve never known pain like it, and that’s exactly what I told my parents.
If you’re with a partner, don’t let embarrassment stop you – just as it shouldn’t stop you telling a parent or caregiver. A caring partner would rather you tell them and get it sorted than have you hide in awkwardness.
Whoever you’re telling, if they can see that you’re physically in pain, that will go a long way to explaining how you feel more than words ever could.
Surgery
Emergency treatment is needed to prevent long-term damage or even the loss of the testicle. Even if sudden testicle pain comes and then goes away on its own, medical care is important. A testicle can twist and untwist on its own, and then twist again.
My dad drove me to the emergency room and—despite the pain being so intense I only remember fragments—I remember stumbling into the waiting room in my pajamas clutching an empty candy tub I was using as a barf bowl.
I was checked over. I don’t remember much in my case, but you can expect questions to help determine whether it’s torsion or something else that’s causing your symptoms. Some might sound repetitive or involve things that are already in your medical chart, but your doctor wants to be thorough.
In a physical exam, a doctor might lightly rub or pinch the inside of your thigh on the side that’s affected, because this usually causes the testicle to contract. When you have testicular torsion, the reflex might not happen.
If it makes you feel more comfortable, you can ask someone to stay with you in the exam room. They may also be able to help answer questions if the pain is making it hard for you to think.
Doctors determined that I was suffering from testicular torsion, so I was promptly taken via ambulance to a hospital in the next town over, which had the best facilities for my condition.
I needed surgery to save my testicle. Previously, I’d always been a bit scared of general anesthetic, but the pain was so severe I just wanted it to end.
Surgery is usually done under general anesthesia. It’s relatively simple: the surgeon makes a small cut in the scrotum, untwists the spermatic cord and stitches one or both testicles to the inside of the scrotum.
The sooner surgery takes place, the higher the chance of saving the testicle. Fortunately, I was able to undergo surgery soon enough that my testicle was saved.
You usually leave the hospital the same day, unless there’s a complication. I woke up and ate some toast in the hospital and a couple of hours later I was discharged and recovering at home.
What’s recovery like?
For me, recovery went pretty smoothly. I had to wear a fabric contraption that supported my testicles and the area was pretty sore for a while. As it happened right at the start of my two-week Christmas break from school, I didn’t need any time away from school, apart from an afternoon or two for hospital appointments a few weeks down the line.
However, I struggled a little mentally. It was a combination of the embarrassment I felt and the concern in terms of what it might mean for the future. I wasn’t sure whether it would affect my potential fertility, and I didn’t know at the time whether or not I’d want children someday—I wanted to leave my options open.
In truth, going through testicular torsion doesn’t necessarily mean you’ll run into fertility issues. Even when someone loses one testicle, the other can produce enough sperm and hormones to maintain normal fertility levels, something I wasn’t aware of at the time.
FYI, some people decide to have a sperm count test a few months after experiencing torsion to check on sperm count, motility and shape. At 14 or 15, it wasn’t exactly my priority, and it’s not something I’ve ever felt the need to do, but the option’s there for those who want it.
Another mental side effect of testicular torsion was that it made me more hesitant to have sex as I got further into my teenage years. I was worried about hurting myself again, or that something might have changed permanently, even though I’d recovered well physically.
In reality, having testicular torsion doesn’t mean you’ll have any lasting problems. Once you’ve recovered from surgery, there’s no reason you can’t be sexually active. And because surgeons secure the testicle during surgery, having torsion once does not mean you’re more susceptible to having it again and a repeat case is rareexternal link, opens in a new tab.
As for your long-term health, you don’t need to take any special precautions. And while you’re not required to share this part of your medical history when you’re dating or sleeping with someone, you certainly can. Telling them can feel like another hurdle in itself, but what I’ve found is that people react more with concern than judgment. And you don’t need to go into too much detail. Simply telling them you had surgery on one of your testicles is enough, and you can explain that it doesn’t have any effects on your sexual health today
Looking back, it’s easy for me to see as an adult that there was no reason to be embarrassed, and that I did the right things. If anything, I’m pleased that I was able to be frank with my parents and speak up, as awkward as it felt.
So here I am, more than a decade later. I don’t think about my testicular torsion all the time—it’ll sometimes come up if I’m talking to friends and we’re discussing the worst pains we’ve ever experienced. Sharing my story also raises awareness about this rare, but very serious, medical emergency.
If there’s one piece of advice you take from this, make it that, if you experience sudden severe pain in one testicle, or a friend or loved one tells you they do, don’t wait to see if it goes away.
Going to the emergency department as quickly as possible could make all the difference.
