If your testicle hurts, and possibly, if both of your testicles hurt, this could be the sign of an emergency room situation. Nuts! This could be a testicular torsion which is a result of the twisting of the vascular tissues which feed the testicle. And what happens when you pinch or twist a garden hose? Yep. No more fluid flow. When the arteries and veins are pinched or twisted as is the case with a testicular torsion there is decreased blood flow to and from the testicle.
If you have had a sudden onset of testicular pain you need to seek medical attention. This is because once the blood flow has been restricted to the testicle you have approximately six hours to restore the blood flow surgically before the testicular tissue begins to die! Yikes! Don’t go nutless, go to the emergency room.
It is possible that the pain in your testicle is from a torsion of the testicular appendages (ie blood flow restricted to a portion of the testicle, or to the epididymis–an organ that is right next to the testicle). But you likely won’t be able to tell on your own, and why take the risk? Testicular salvage rate is about 100% if you get surgical intervention within 8 hours. So if you’re reading this and this is you, go get it checked out at your local Emergency Room.
If you just want to learn more, here’s what is happening with the testicular torsion: Most testicular torsions are due to a congenital abnormality. (Remember, don’t be intimidated by medical speak. It’s merely caveman latin). “Congenital abnormality” merely means that it is something that a man is born with. What is this man born with? Great question. He is born with what is called a “bell-clapper” deformity (aptly named, no?). The inner sheath that wraps around the testicular tissues attaches much higher on the scrotum in individuals with a bell-clapper deformity.
Imagine you have a bag of oranges from the grocery store. However, this bag only has one orange in it. Imagine holding the bag up in the air with one hand while rotating the orange while it is still in the bag. The bag gets twisted all the way from your hand holding the bag down to the orange. Now imagine holding the bag in such a way that the orange is now very close to the hand holding the bag. Now imagine trying to rotate that orange. In the second scenario, the orange can’t rotate very much, but in the first scenario the orange can rotate enough that the bag gets seriously twisted. That mesh is torsed, and if there were blood flow to that orange running through that mesh….it would no longer be running to that orange.
With a testicular torsion, the mesh represents the tunica vaginalis, and the hand holding the bag represents the congenital abnormality of the attachment site being farther up on the scrotum. So, what can be done about this? First of all, if you have testicular pain with a sudden onset go to the Emergency Room. An ultrasound to rule it out is cheaper than a testicular prosthetic, and that’s not even mentioning…well, you get it: No man wants to lose one of his boys. When the surgery is performed to correct the torsion this will allow the blood flow to return to the testicle, and then they will perform what it’s called an orchiopexy. An orchiopexy is where they attach the testicle to the scrotum to make your testicle more like the second scenario with the orange in the bag where the testicle can no longer rotate enough to cut off blood supply.
Now, if what you are experiencing is not acute testicular pain (and a possible torsion) and you have been living with testicular pain for several weeks or months there is also help for that. Reach out today to Renewal Physical Therapy or to your local Men’s Health physical therapist to find out what kind of help may be available to you!
Soli Deo Gloria,
Todd Rundell, Doctor of Physical Therapy
Men’s Health Specialist
P.S.
At Renewal Physical Therapy we want to give our patients the tools to take care of their body so they can spend less on medical professionals and more on the rest of their lives. The first step in this process is making sure our patients are well educated. We are happy to answer your questions or to send you more material to help you better understand your condition. Just reach out to us!