Testicular torsion in children: why prompt medical attention is crucial

Children’s testicular pain is frequently brushed off as a minor injury, or it is assumed that it will go away on its own. Testicular torsion is one condition though, where a delay could mean the difference between saving or losing the testicle. Raising parental awareness is the first line of defence against long-term effects.

Understanding testicular torsion

When the testicle twists around the spermatic cord and cuts off its blood supply, this condition is known as testicular torsion. The testicle may sustain permanent injury if treatment is not given immediately, typically within four to six hours.

Although it can happen at any age, newborns and children as well as teenagers during purberty are more likely to sustain this condition, when growth spurts cause the testicles to become more mobile. Timely intervention is critical. Taking the pain seriously and seeking immediate medical care can ensure the testis is saved.

Children might not always be able to express their symptoms as well as adults do. Parents need to be aware of any unexpected changes, such as: sudden, severe pain in one testicle, scrotal swelling or redness, nausea and vomiting, the child walking awkwardly, refusing to sit or play and pain that comes on after a minor injury but continues to worsen.

Children frequently arrive at the emergency room hours after the pain starts, which can significantly lower the testicle’s chances of survival. Awareness is key. Teenagers, young adults, and parents must be educated about the symptoms of testicular torsion and the need for immediate medical attention. Until proven otherwise, treat scrotal pain in children as an emergency.

Treatment and prognosis

A physician can confirm the diagnosis through an examination or with an ultrasound.

Emergency surgery to untwist the spermatic cord and fix both testicles is the standard treatment for testicular torsion in order to prevent recurrence. The testicle can be saved if blood supply to it is promptly restored. Delays longer than six to eight hours, however, significantly reduce the affected testicle’s chances of surviving.

In cases where the testicle cannot be saved, removal may be required. Even then, with one healthy testicle, boys usually maintain normal fertility and hormonal function. Although a normal sexual life and good quality of life are possible even with a single testis, the goal should always be to preserve both, for the physical and psychological well-being of the individual.

Tips for parents

There is no guaranteed way to prevent torsion, but awareness makes all the difference.

• Do not dismiss sudden testicular or groin pain in children.

• Seek immediate emergency care rather than trying home remedies.

• Encourage older boys to report any scrotal discomfort without embarrassment.

Fast action can preserve fertility and prevent future complications.

Although testicular torsion is uncommon, it can have major consequences. The testicle can be saved and long-term effects can be avoided with early detection and prompt treatment.

(Dr. D. Venkat Subramaniam is senior consultant urologist & executive director at Asian Institute of Nephrology and Urology, Chennai. drvenkat@ainuindia.com)