In the fetus the testicle develops within the abdomen and migrates down into the scrotum, trailing its blood supply behind it like a leash. In the scrotum the testicle resides within a smooth sack called the tunica vaginalis. The testicle can spin and move about within the sack. As males grow and age the testicle develops connections with the sack making it harder for the testicle to spin or twist. This is why torsion is usually seen in younger men, adolescents, and children.

It can occur during fetal development leading to neonatal torsion or vanishing testis and is one of the main cause for monarchism (single testicle).

It needs emergency treatment to save the testicles. Other wise it can lead to permanent damage to the testicles leading  to necrosis of testis and atrophy of testis. It can lead to sterility

Signs and symptoms of testicular torsion

• Severe sudden pain in the scrotum.
• Swelling of the scrotum.
• Redness of skin of the scrotum.
• Lower abdominal pain.
• Fever.
• Testicle is positioned at an higher level than normal or at an odd angle.

Tests and diagnosis

• Physical examaintion.
• Urine analysis.
• Testicular ultrasound.
• Nuclear scan of the testicles.
• Surgical exploration.

Treatment of testicular torsion

• Manual detorsion of the torsed testis can be attempted. It is difficult since it is very painful and may not be successful.
• Testicular torsion is an medical emergency requiring immediate treatment. It is called orchidopexy.If treated with in 6 hours 100% chance are there for saving the testicle. During surgery the testicle on other side is also anchored as a preventive measure.