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Testicular torsion
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Testicular torsion means that the spermatic cord twists on itself. That cord is the bundle that holds up the testis and carries blood vessels in and out of it, so when the cord twists its blood supply twists too. It is a true urologic emergency.
The damage comes in two stages. First venous outflow is strangled, and then come venous congestion, meaning stagnant blood, and ischemia, which means lack of oxygen in the tissue. If the testis keeps turning, arterial inflow is cut off as well, and then the tissue dies: that is necrosis. It is like a hose twisting shut: the outflow is strangled first and eventually the inflow too.
Whether this can happen depends on the anatomy. Normally the tunica vaginalis, the covering of the testis, is firmly attached behind it and the cord does not move inside it. When that insertion is high, the cord is left loose and can rotate: this is the bell clapper deformity, so named because the testis hangs and swings like the clapper inside a bell, and it is present on both sides in at least two of every five cases.
In brief
Testicular torsion is twisting of the spermatic cord and of the testicular blood supply: a urologic emergency.
As it twists, venous outflow is cut off first, causing congestion and ischemia; if it continues, arterial flow is cut off and the testis becomes necrotic.
Like a hose twisting shut: the return is strangled first and eventually the inflow too.
A high insertion of the tunica vaginalis makes it possible, leaving the cord mobile: the bell clapper deformity, bilateral in at least two of every five cases.
Sources (1)
- National Center for Biotechnology Information, StatPearls PublishingTesticular Torsion, StatPearlsPublished
This page explains the topic in general terms; it does not tell anyone what treatment to follow.
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