What is Reduction Torsion?
Testicular torsion is the twisting of the spermatic cord, which cuts off the blood supply to the testicle and surrounding structures within the scrotum. Reduction torsion is a procedure that corrects this condition.
Effects of Reduction Torsion
Candidates for Reduction Torsion
Testicular torsion affects males only. Testicular torsion most often is observed in males younger than 30 years, with most aged 12-18 years. The peak age is 14 years, although a smaller peak also occurs during the first year of life.
There are only a few guidelines for this procedure such as not eating or drinking before undergoing the surgery. Other guidelines are dependent on the physician or the facility where Reduction Torsion will be performed. Pre-procedure instructions or guidelines should be provided by the physician.
The Reduction Torsion Procedure
A simple surgery will correct and prevent testicular torsion. It can be done in an emergency situation after determination that the testicle is cut off from blood supply or as an outpatient procedure for patients who have experienced frequent episodes with testicular torsion. If necessary, the surgeon will first untwist the testicle(s). The surgeon will then permanently suture the testicles to the inner lining of the scrotum. If only one testicle has been problematic, the surgeon will still suture both testicles as a preventative effort.
Whether the testicle is removed or not, scrotal exploration results in minimal and short-lived discomfort. Oral pain medication may be necessary for a few days. Most surgeons will allow the patient to return to work or school within a few days to a week. However, strenuous physical activity or exercise might be best avoided for several weeks. The sutures that are placed around the testicles are not perceived by the patient and are not bothersome. It would be very rare for torsion to recur after the placement of fixation sutures. Patients and families should be wary of any testicular pain or swelling, however, especially if there is only one remaining testicle. In that case they should seek medical attention immediately.
If the blood supply is cut off to the testicle for a prolonged period of time, it may atrophy (shrink) and need to be surgically removed. Atrophy of the testicle may occur days to months after the torsion has been corrected. Severe infection of the testicle and scrotum is also possible if the blood flow is restricted for a prolonged period.
What are torsions?
Torsions are sometimes called “winter syndrome”. This is because they often happen in winter, when it is cold outside. The scrotum of a man who has been lying in a warm bed is relaxed. When he arises, his scrotum is exposed to the colder room air. If the spermatic cord is twisted while the scrotum is loose, the sudden contraction that results from the abrupt temperature change can trap the testicle in that position. The result is a testicular torsion
What causes torsion?
In most males, the testicles are attached to the inner lining of the scrotum. Males whose attachment is higher up are at risk of testicular torsion. This condition is known as a bell clapper deformity (as in the central piece of a bell) and is a major cause of testicular torsion. A male who notices the ability of either or both testicles to freely rotate within the scrotum should be aware that he is at risk of testicular torsion. Testicles that are in a much lower position and/or in a slightly rotated position in the scrotal sack are a visual indicator of this risk.
Who is affected by torsion?
Some men may be predisposed to testicular torsion as a result of inadequate connective tissue within the scrotum. However, the condition can result from trauma to the scrotum, particularly if significant swelling occurs. It may also occur after strenuous exercise or may not have an obvious cause. The condition is more common during infancy (first year of life) and at the beginning of adolescence (puberty).
What does testicular torsion feel like?
Boys with testicular torsion get sudden pain and swelling of the scrotum. The testicles become sore. The condition may be so painful that it causes nausea and vomiting. It will mimic infection (acute epididymo-orchitis) but it is very important to seek urgent treatment.