Lifestyle & Health : Worried after surgery on twisted testicle

November 01, 2016

Keon is a 24-year-old young man who recently had surgery to fix one of his testicles which had twisted inside the sac. The surgery went alright but Keon is worried that the twisting problem could affect his ability to have children.

The first answer is that most men have two testicles, just like women have two ovaries and people are born with two eyes and two kidneys. Father God, in his great mercy, has provided us with 'back-ups'! What that means is that if we lose one of those organs we are still 'good to go', so long as the other of the pair is in good working condition.

Check UP can refer to more than one woman who have birthed multiple children after losing an ovary, and the same is true of a man. Keon still has both his testicles, so he is still ahead in that situation.

The follow-up answer is that testicular torsion can reduce fertility in some individuals. What occurs is that the testicle becomes twisted and the blood supply to it can be shut off, in part or whole. The testes are protected by the spermatic cords which get twisted around the testes and can stop the blood supply to the testes. If this condition occurs and is not corrected surgically within a half-day or so, then it is likely that some function capability may well be lost.

The cause is unknown for the most part, but it has been observed to occur at times after strenuous activity. Often, there is no associated cause at all. Testicular torsion causes severe pain of sudden onset with associated swelling of the affected testicle, which is very tender. Outcomes are best when surgery, orchiopexy, is performed immediately and the torsion corrected. In some men who delay seeking attention, the testicle is permanently damaged and possibly cannot be saved. It may then need to be removed. Symptoms include:

• Sudden, severe scrotal pain (pain in the sac).

• Swelling of the sac.

• Abdominal pain.

• Nausea and vomiting can occur.

• Painful urination.

• Fever.

Even when symptoms like these occur but go away, the man should still visit his doctor for a check-up, as the testicle may have twisted then untwisted itself. This is good, but corrective surgery will be needed to prevent the very high likelihood of the twisting recurring, with bad outcomes. The more frequent the bouts of pain, the more damaged the testicle becomes. The person with one twisted testicle is more likely than other men to experience this in the other testicle also, so if the condition is not addressed the man truly risks infertility.

The doctor will send the man for a scrotal ultrasound when this condition is suspected, but time is of such essence that it is best to be referred directly to hospital for surgical correction than to delay to do the ultrasound. They will sort all that out at the hospital!

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