The day just dawned, the high school student A was suddenly awakened in his sleep by a sharp pain in his lower body, he felt the pain were cold sweat, the small stomach also began to hurt. A thought it might be caused by cold or yesterday’s “bad food”, plus the pain area is also more embarrassing, A did not immediately tell his parents, as a dang “man” think to endure it will be fine. It was not easy to get to school, just to start class, little A will not be able to hold on, only to see little A pale, full of sweat. The table saw the situation and hurriedly asked for leave to send him to a small clinic near the school to get an IV. The pain did not improve until the night, A rushed to call his parents, sent to the local hospital to confirm the diagnosis, the original A has a kind of emergency – testicular torsion. Unfortunately, because it was too late to send the doctor, the examination revealed that one of A’s testicles had become necrotic, and finally had to be surgically removed. The testicles are the most important male sex organ, with physiological functions such as producing sperm and secreting androgens. However, due to our traditional social concept, we did not learn about physiology systematically since we were young, and we are too shy to talk about this content when we grow up. We know very little about this important organ, once the “there” feel pain or discomfort, but also ashamed to say, as a dang “man” will feel tolerated on it. The actual fact is, this is not only not “sea and sky”, and may cause regret for life. The pain may be an alarm of testicular and epididymal lesions, of which testicular torsion is one of the most critical. What is testicular torsion? Testicular torsion, also known as spermatic cord torsion, is one of the most common causes of scrotal emergencies. It is also one of the most common causes of testicular loss in young men, making it a veritable “testicular killer”. Testicular torsion can occur in newborns to older adults, but it is most common in adolescents, between the ages of 12 and 18. How does testicular torsion occur? In a normal male, there is an oval-shaped testicle on each side of the scrotum, which is connected to the body by a cord-like tissue called the spermatic cord, the main artery that maintains the blood supply to the testicle. Our testicles are wrapped in a sphincter and are surrounded by ligaments that hold them in place, so testicular torsion does not normally occur. The pathogenesis of testicular torsion is not well understood, but is currently considered to be related to anatomical abnormalities. When the sphincter wall layer extends too high in the spermatic cord, the testicular tether or the testicular lead is too long, it increases the mobility of the testicle, and with the rapid growth of the testicle during puberty, torsion is more likely to occur. Most testicular torsion occurs without obvious triggers, and some patients may occur during sleep or just after waking up, probably because the vagus nerve is excited during sleep and the levator muscle contracts and strengthens with the erection of the penis, and if combined with anatomical abnormalities, torsion is more likely to occur at this time. In some patients, it occurs after strenuous exercise, sexual intercourse or trauma. In addition, it can be triggered during the cold season or when the weather suddenly turns cold. How to distinguish testicular torsion? When testicular torsion occurs, the spermatic cord and testicular artery can also be twisted, resulting in a significant reduction in blood flow or blockage of inaccessibility. As you can imagine, the spermatic cord and arteries are twisted into a “twist”, can blood still pass through them? At this time, the testis is continuously ischemic and the venous return is obstructed, various pathologies will occur, such as testicular atrophy and necrosis. The typical symptoms of testicular torsion are sudden enlargement of one side of the scrotum, pain to the touch, which can increase significantly within minutes or hours; this pain can spread to the groin, thighs and lower abdomen, which can be easily mistaken as a simple “stomach ache”. In some cases, the pain may be accompanied by nausea, vomiting and fever. Examination may reveal a swollen scrotum that is painful to the touch; if the swollen side of the scrotum is held up, the pain may worsen instead of being relieved. It is urgent to save the testicle KU torsion is one of the urgent urological cases, and the key to its successful treatment is the time and degree of torsion. Studies have shown that ischemia within 2 hours does not affect sperm production and endocrine function too much; if the ischemia time is longer than 6 hours, sperm production and endocrine function will be impaired; if it is longer than 10 hours, testicular function will be completely destroyed. Therefore, if the testicle is treated promptly within 6 hours, the “suffocated” testicle can be saved; if it is treated within 6-12 hours, the testicle survival rate is about 70%; if it is treated within 12-24 hours, the testicle survival rate plummets to 20%; if it is more than 24 hours, the testicle basically has no chance of survival. In addition, it is important to understand that the survival of a salvaged testicle does not mean that its function is unaffected, and some of the salvaged testicles may slowly atrophy. This is because this ischemia-reperfusion injury is irreversible. What should we do if the scrotum is painful? Testicular torsion often occurs without warning, either during sleep or just after waking up. The sudden and severe pain can easily disrupt sanity, so that when the doctor asks about the condition it is often already difficult to recall exactly when the pain started, what triggered it, etc. Some patients may be triggered by accidental collision after strenuous exercise or while playing, therefore, it also often confuses doctors in diagnosis and is mistaken for testicular trauma, rupture or bruising. In addition, it is similar to the clinical manifestations of orchitis and epididymitis, so it is also often misdiagnosed as orchitis and epididymitis and delayed in treatment. Therefore, once scrotal pain occurs, we should not be careless. Especially when scrotal swelling and severe pain suddenly appear in teenagers after strenuous exercise or during sleep, parents should be more vigilant and should not be lax in seeking timely medical attention. Psychological counseling after misfortune If testicular torsion is not treated in time, only one side of the necrotic testicle can be removed in the end. This kind of misfortune will undoubtedly have a huge psychological shadow on the teenagers who are still in their adolescence. If there is no timely and correct psychological counseling, pessimism and low self-esteem may affect the shaping of character. The fact that you are missing a “ball” does not affect your manhood, nor does it affect your future sexual function and fertility, because the other side of the testicle has the ability to compensate. As we all know, Chen once fell from the stage during a concert and had to have his testicles removed because the damage to one side was too severe. However, his normal life is not affected in any way at present. Therefore, we do not need to be pessimistic and depressed. Summary The treatment of testicular torsion is not complicated, and the key lies in early detection. Once the testicular torsion is diagnosed, surgery should be performed as soon as possible to preserve the testicle and to maximize its reproductive and sexual function. After recovery from surgery, a routine semen examination should be repeated to understand the current function of the testicles, which is especially important for unmarried men. ”Egg pain” is not that simple. So once you have scrotal pain, don’t ignore the possibility of testicular torsion and seek medical attention.