How do you know if your testicles are reversed?

Testicular torsion usually presents with symptoms such as sudden severe pain, swelling in the scrotum, and upward movement of the testicles. It can be diagnosed through physical examination and ultrasound examination. Testicular torsion is a urological emergency and requires surgical reduction within 6 hours to avoid testicular necrosis.

The typical symptom of testicular torsion is sudden, severe pain in the scrotum on one side, which may radiate to the groin or lower abdomen. Patients can often accurately describe the time of onset of pain, which often occurs after strenuous exercise, sleep, or cold stimulation. The scrotum on the affected side will rapidly become swollen and red, the testicles will move upward and become transverse due to torsion of the spermatic cord, and the cremasteric reflex will disappear. Some patients are accompanied by systemic symptoms such as nausea, vomiting, and low fever. Testicular torsion in newborns may only present with non-specific symptoms such as irritability, crying, and refusal to eat.

Clinical diagnosis mainly relies on medical history and physical examination. The doctor will perform Prehn's sign test (pain in the scrotum that is not relieved by pushing up the scrotum) and cremaster muscle reflex examination. Color Doppler ultrasound is the gold standard for diagnosis and can show that the testicular blood flow signal is weakened or disappeared. Pay attention to the identification of epididymitis, orchitis, strangulated hernia and other diseases. For those with high suspicion but unclear ultrasound results, radionuclide scanning or emergency surgical exploration may be considered.

Immediate surgical reduction and fixation is required after diagnosis, and the golden rescue time is within 6 hours after onset. The operation uses a scrotal incision or an inguinal incision. After the torsion of the spermatic cord is reduced, the color recovery of the testicles is observed. Necrotic testicles need to be removed. The contralateral testicle needs to be fixed at the same time to prevent torsion. After surgery, you need to stay in bed, avoid strenuous exercise, and check testicular blood flow regularly. Daily care should be taken to avoid scrotal trauma and protective gear should be worn during exercise. Teenagers who experience recurring scrotal pain should seek medical attention promptly.