PSA for Parents of Boys: Testicular Torsion
A few weeks ago, one of my dear friends informed me that her son had emergency surgery for testicular torsion. Serendipitously, at a recent check-up, their pediatrician spent several minutes teaching her sons about their anatomy and the importance of telling a grown-up if they ever experienced intense pain in the groin area. So when her son woke her up in the middle of the night with scrotal pain, he told her: I think I have what the doctor was teaching us about. Fortunately, rather than second guessing his concern or waiting to see if the pain subsided, she took him to the emergency room right away, giving the surgeons plenty of time to salvage her son’s testicle and future fertility.
What is testicular torsion?
The testicles hang in the scrotal sac, suspended from the spermatic cord, which carries their blood supply. If the spermatic cord twists, the blood supply to the testicles is compromised, and left untreated, this results in the loss of the testicle. Restoring blood flow to the testicle in a timely fashion can preserve testicular tissue and fertility.
How common is it and why does it happen?
Testicular torsion occurs in around 1 in 4,000 males under 25. The most common cause for torsion is an anatomical deformity that allows the testicles to move more freely rather than be anchored in place against the scrotal wall. Unfortunately, this anatomic variance can not be diagnosed by looking at or feeling the testicles. Rapid growth of the testicles during puberty, vigorous exercise, injury, a family history of testicular torsion, or exposure to cold weather may contribute to torsion. But notably, more than half of cases have no known triggers.
What you and your tween should know about testicular torsion.
While testicular torsion can happen in any age group, it most typically occurs during adolescent years, peaking in 10-12 year-olds. Since talking about groin or scrotal pain can be embarrassing for young boys, parents may need to probe if a child seems extremely uncomfortable, perhaps doubled over with what seems like abdominal pain or even vomiting in pain. Frequently, testicular torsion presents as severe pain that awakens an adolescent from sleep. Restoring blood flow to the testicle as soon as possible makes a difference, with over 95% of cases which undergo repair within six hours resulting in successful salvage of testicular tissue. Prolonged symptoms may necessitate removal of the testicle. In one cohort analysis in the Journal of Urology, 40% of boys presenting with torsion lost the affected testicle.
The Breakdown
Penises and testicles are hard to talk about. And while torsion is much rarer than appendicitis or a broken bone, delaying the diagnosis by even a few hours can cost the testicle and its future fertility. As an informed parent, you can raise the subject with the young men in your family and, if needed, act quickly for testicular preservation.
You may also enjoy Boys , Why Is The Doctor Looking At My Kid’s Private Parts… At Every Visit? And Girls, Why Is The Doctor Looking At My Kid’s Private Parts… At Every Visit? Or Growth Charts 101: From Basic to Nuanced.
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References:
Mao, Changkun et al. “Development of a nomogram to predict risk factors for orchiectomy after testicular torsion in children.” Scientific reports vol. 15,1 15154. 30 Apr. 2025, doi:10.1038/s41598-025-97911-6
Zhao, Lee C et al. “Pediatric testicular torsion epidemiology using a national database: incidence, risk of orchiectomy and possible measures toward improving the quality of care.” The Journal of urology vol. 186,5 (2011): 2009-13. doi:10.1016/j.juro.2011.07.024