MedlinePlus Medical Encyclopedia: Testicular infection or torsion

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Testicular infection or torsion

Contents of this page:
Illustrations Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Expectations (prognosis) Complications Calling your health care provider Prevention

Illustrations

Male reproductive anatomy

Male urinary tract

Blood in semen

Testicular torsion repair - series

Male reproductive system

Definition Return to top

Testicular infection or torsion is a group of disorders in which testicular pain is a primary symptom.

Causes, incidence, and risk factors Return to top

Disorders associated with testicular infection or pain include epididymitis, orchitis, testicular trauma, and testicular torsion.

Epididymitis is an inflammation of the epididymis (the structure that is the first part of the duct draining each testis). Orchitis is an inflammation of one or both of the testicles. These disorders may be caused by numerous bacterial and viral organisms. Epididymitis is the most common cause of scrotal or testicular pain in individuals over 18 years of age.

Testicular torsion is a twisting of the spermatic cord, artery and vein, which cuts off the blood supply to the testicle and surrounding structures within the scrotum. If not corrected promptly, the tissues of the testicle will die.

Diagnosis and surgery should take place within 6 hours. If surgery is delayed more than 6 hours, the testicle will often need to be removed. Testicular torsion is the most common cause of scrotal or testicular pain in boys and non-sexually active adolescents. The majority of cases of testicular torsion are in boys less than 6 years of age.

Symptoms Return to top

Sudden onset of testicle pain (in one or both testicles) with or without a predisposing event
Scrotal swelling
Extreme tenderness to pressure or traction on the testis

Specific to orchitis and epididymitis:

Fever
Chills or chilling sensation
Discharge (fluid) from penis

Additional symptoms that may occur:

Testicle lump
Blood in the semen
Nausea/vomiting
Light headedness or fainting
Blood in the semen
Pain with urination
Pain with intercourse or painful ejaculation
Groin pain

Signs and tests Return to top

Physical examination is often sufficient to diagnose testicular torsion, orchitis, and epididymitis. Radiographic tests may be required to differentiate testicular torsion from infectious causes of testicular pain. Often, tests will be needed to determine the causative organism for infections.

Treatment Return to top

If the cause is bacterial, epididymitis and orchitis may respond to antibiotics. Pain medications (analgesics) and other treatments may be recommended.

Prompt surgery is required for testicular torsion.

Expectations (prognosis) Return to top

With appropriate diagnosis and adequate treatment, normal function of the testicle is usually preserved. If the infection is severe or testicular torsion is not surgically corrected promptly, infertility and testicular atrophy (shrinkage) may result.

Complications Return to top

Loss of testicular function (infertility)
Severe infection

Calling your health care provider Return to top

Any time there is persistent or severe testicular pain, with or without any of the other symptoms listed above, call your health care provider promptly.

Prevention Return to top

Epididymitis and orchitis are frequently, but not always, associated with sexually-transmitted diseases.

There are no special preventive measures for testicular torsion. A high index of suspicion and early diagnosis and surgery will prevent loss of a testicle.

Update Date: 11/3/2003

Updated by: Scott M. Gilbert, M.D., Department of Urology, Columbia-Presbyterian Medical Center, New York, NY. Review provided by VeriMed Healthcare Network.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.