A 'twisted testicle' is a more crude and descriptive way of referring to a testicular torsion, sometimes simply referred to as a torsion. This term is better for occasions where you wish to provoke extra sympathy from somebody, or, if talking to a fellow male, if you want to make them keen for a change of subject. Most effective when describing to your boss the reason that you won't be seen at work for a fortnight.

What is it?

As the name implies, it occurs when the spermatic chord which attaches the testes to the scrotum, becomes twisted; cutting off the blood supply.

It is notoriously painful and is usually noticeable immediately by acute pains and aches in the affected testicle.

What causes it?

There can be a number of causes, but more often than not it is due to loose fitting underwear and can occur after vigorous movement or activity.

Sometimes referred to as 'winter syndrome', because colder temperatures can cause the scrotum to shrink, tightening itself. Lying in a warm bed, for instance, the muscles will relax and if suddenly exposed to cold air, will contract quickly. If a testicle is lying in an awkward position, it can become trapped that way, twisting the spermatic chord.

It is also common as a sporting related injury, especially in rough, contact sports.

Treatment?

Fast treatment is crucial if a testicular torsion is suspected. Within 12 hours without a supply of blood, there is still a 70% chance that the testicle will survive, after this the chances drop significantly and after 24 hours, it is likely to die. If not removed at this stage, it will eventually cause a gangrene infection.

Luckily, the operation is usually an easy one. Using a small incision in the scrotum, surgeons will untwist the testicle, and then make a small stitch to attach each testicle to the scrotal wall, to prevent any future torsions*.

How to avoid twisting your testicle

Having struggled through the busy streets of London to the nearest hospital with an agonising pain in my groin, having been put through the above operation, and endured the following few days of bleeding and seepage from the wound. Having had to try to describe the delicate location of my pain to a receptionist, in front of a busy, yet quiet waiting area, I would advise all men to take extra note of the following tips :

• Don't wear loose-fitting, or no underwear to bed. You may feel more free, but your testicles are at risk if you get up too quickly.

• Have your heating set to turn on before you get out of bed. If it's cold, don't get up too quickly.

• If you DO think you have a twisted testicle, go to a doctor or hospital immediately, especially if you ever plan on having children.

• When you arrive at the hospital or surgery, instead of struggling over how to explain your painful testicle to the receptionist in front of a crowd of onlookers, you now know how to explain it simply. With a subtle point to your groin, utter, “I think I'm suffering from a torsion.” No embarrassment, and I guarantee you'll be the very next person to be called.

*I can now safely say that I will never suffer from a testicular torsion

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