Testicular Torsion In Children: Causes, Signs And Treatment Options

A] Signs Of Testicular Torsion In Children

There are several signs that can indicate testicular torsion in children. By looking out for these signs, you can safeguard the well-being of your child well in advance.

In Infants (0–3 Years)

Unlike adults, babies are often not able to express their pain clearly. Instead of verbal clues, parents can watch out for signs such as sudden crying, reduced appetite or a scrotum that appears swollen. Another key sign to note is tenderness near the infant’s diaper area.

In Children (4–10 Years)

Unlike infants, children here are able to express their pain properly. However, they may not be able to do it with appropriate words. Signs here can involve sudden pain in one testicle, intense pain in the lower abdomen region, nausea, and even vomiting in certain cases. Read our blog to know more about the various causes of abdominal pain in children.

In Teenagers (11–17 Years)

More severe cases are commonly reported in this age group. Not just swelling; even your scrotal skin becoming red could be noticed. If your testicle position appears higher than usual, it could actually be considered a red flag. While signs such as dizziness or vomiting could be considered irrelevant, they could actually denote testicular torsion.

B] What Are Some Causes Of Testicular Torsion In Children?

From anatomical to natural body reflex, the testicular torsion in children can be caused by several factors. Some of these include:

Bell-Clapper Deformity

Bell-clapper deformity is one of the most common causes of testicular torsion in children. Here, the testicle is attached to the inner wall of the scrotum at the back. The trouble arises when this attachment becomes weak. This makes it swing like a bell, as the name suggests.

Rapid Testicular Growth During Puberty

Testicular torsion mostly occurs between the ages of 12 and 16. During this, they can experience massive changes in their reproductive organs due to puberty. It’s said that their testicles can grow 2 or 3 times their original size during this period. This makes it more likely for the testicle to move within the scrotal sac.

Sudden Movements During Sleep

Even sudden movements during sleep, such as rolling over, can cause the cremasteric muscle to contract. This can twist the testicle upward, causing testicular torsion in children. From 4 am to 8 am, boys can witness a rise in their testosterone levels. This, combined with the loose scrotal skin, can be another cause of testicular torsion in children.

Temperature Changes

Something as simple as a change in temperature can also be responsible for causing testicular torsion in children. Many studies have found that cold temperatures around 15-17°C can cause the testicle to go upward. With your cremasteric muscle contracting, this can lead to testicular torsion in children.

C] How Is Testicular Torsion Diagnosed In Children?

Testicular torsion in children is diagnosed by doctors by combining several methods. These can include:

Clinical Examination

A detailed medical history might be noted by your doctor. The symptoms, the duration, and the onset might be asked about. Changes in the visible appearance of the testicle, along with the position, might indicate something.

Doppler Ultrasound

Doppler ultrasound is associated with showing the blood flow in the testicle. When the blood flow is absent or reduced, it shows a possibility towards testicular torsion. Doppler ultrasound can even make the spermatic cord appear twisted or make a whirlpool sign.

Urine Tests

While urine tests are not directly related to testicular torsion, they still help to rule out other conditions. In case of infections, testicular torsion might be ruled out.

Children’s anatomy is different from that of adults. Interpreting results requires the use of a skilled paediatric urologist. Contact Dr Gursev, an experienced paediatric urologist who can guide you in detail about the diagnosis and treatment process.

D] Treatment Options For Testicular Torsion In Children

Urgent treatment of testicular torsion can eliminate the need for surgical options. Treatment of testicular torsion in children should ideally take place within 6 hours. These are certain paediatric surgery options if manual detorsion can’t be done.

Surgical Detorsion

The results of this method work best when done within 6 hours. The procedure first involves the administration of anaesthesia, which is later followed by a small incision in the scrotum. The testicle is later untwisted, and the patient’s blood flow is checked.

Orchiopexy

This procedure is often followed after surgical detorsion. To prevent twisting, the surgeon sutures the testicle to the inside of the scrotum. A key advantage of this procedure is that it ensures quick recovery.

Orchiectomy

An orchiectomy can be performed if the twisted testicle has suffered irreversible damage. Removing the testicle in this case ensures no further infections and complications are caused. Parents don’t need to be concerned, as fertility is not affected due to the presence of the other testicle.

A skilled paediatric urologist can help you prevent complications often involved in testicular torsion surgery. Consult Dr Gursev, a superspecialist who has 20+ years of experience at several reputed hospitals in Mumbai and Dubai.

E] Recovery After Paediatric Testicular Torsion Surgery

There are certain steps you need to take care of after a testicular torsion surgery. These involve:

1. Taking your prescribed medicines on time.
2. Keep the surgical site dry and clean, at least for the first few days.
3. Avoid activities such as running, cycling or jumping for a few weeks.
4. Sponge baths are an excellent choice in the first 2-3 days.
5. Avoid home remedies such as applying ice to the affected area.
6. Even when your healing process is on track, we suggest a follow-up appointment with your doctor.

For more tips, refer to our blog on preparing your child for surgery with detailed age-specific advice.