Sudden, severe testicular pain should always be taken seriously.  It can be a sign of testicular torsion, a dangerous condition that requires immediate surgery.

Testicular torsion occurs when the spermatic cord inside one testicle becomes twisted, which cuts off blood supply to the testicle.  If surgery isn’t performed within 6 to 12 hours, then the testicle might have to be removed.  There is even the danger of permanent infertility.

While testicular torsion can occur at any age, it is most common between the ages of 12 and 20.  Rapid growth of the testicles during puberty can cause torsion, as can exercise or an injury.  However, torsion can occur during inactivity, even while asleep.

If your son complains of extreme testicular pain, even if it goes away, report this to your pediatrician.  According to the American Academy of Pediatrics (AAP), up to 50 percent of patients with testicular torsion have had scrotum pain before.

Other symptoms:  the scrotum can become enlarged, red, and very painful; abdominal pain may accompany torsion, along with nausea and vomiting.

The AAP article also tells how the condition is diagnosed:

• “Physical examination by a urologist;
• Urinalysis, to detect presence of white blood cells;
• A radionuclide scan or scrotal doppler ultrasound, to assess blood flow to the testicles;
• Some urologists will take a patient with typical symptoms of torsion directly to the operating room.”

The bottom line:  take testicular pain very seriously.  It could be an emergency.

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