– (Érika Onodera/)
The image above illustrates a twisted and a normal testicle. Torsion happens when a tube called the spermatic cord, which connects the testicles to the abdomen, accidentally rotates and «twists». Through this cord pass veins, nerves, lymphatic vessels, the testicular artery and the vas deferens (which conducts sperm). As he is mobile, he can twist with a sharp rotation of one of the testicles. This happens mainly among young people up to 25 years old. In many boys, the tunica vaginalis – that’s right, vaginal, a tissue that covers the cord and testicles – is looser, which makes the balls looser and more likely to move. The main causes are blows or movement in the region during sleep, when it is common, at that age, to have more erections. They cause contractions of the cremaster, a sac muscle, causing rotations of up to 720o. (There!)
– (Érika Onodera/)
1) SACAL EMERGENCY
When torsion happens, it’s common to wake up with intense pain in the bag, which swells. Testicle irrigation is compromised and nausea and vomiting are common. The patient must be taken immediately to an emergency room. The more time that passes, the greater the risk of the ball dying from lack of blood – if that happens, it will need to be removed.
2) BOLADÃO
Ideally, in order not to suffer sequelae, the patient should be seen within six hours of the first symptoms. After more than six hours of the first symptoms, however, there is no guarantee of recovery. In case it is too late to save the twisted testicle, it is removed and a silicone prosthesis is placed in its place, to prevent the teenager from experiencing embarrassment. Whoever removes both testicles has to take testosterone, the male hormone, for the rest of his life.
3) DISTORTING THE FACT
In the hospital, the doctor will do an ultrasound to detect if there is no blood flow in the testicle. Once the torsion is confirmed, he can try to distort the cord manually, turning the ball on the outside, or go straight to surgery. In the latter case, the procedure is simple: anesthesia, opening of the scrotum, distortion and fixation of the testicle. The process takes no more than 30 minutes.
SOURCE Book Sobotta – Atlas of Human Anatomyby Johannes Sobotta
CONSULTANCY David Cardoso, urologist