Patient's question:
[Condition Description: I read a news article about a testicle twisting and dying during sleep, and I also like to sleep on my side. 1. The left testicle is lower than the right, is this normal (someone said it's a normal phenomenon)? Is it? There are no other symptoms. I want to ask if there are any symptoms that can be detected with testicular torsion? 2. If the testicle twists, will it be extremely painful, like a dying sensation? 3. If it's dead, will there be no sperm (can it still be ejaculated)? 4. Will it also lead to impotence? Medical history and treatment effectiveness: There has been no previous treatment. What kind of help do you want: Please answer one by one, do not summarize in one go. Thank you.]Doctor's answer:
The testicle itself does not twist, but the spermatic cord, which resembles a rope, can twist and knot. Since the blood vessels that supply nutrients to the testicle and remove metabolic waste pass through the spermatic cord, once the cord knots, the testicle will be starved. Generally, after more than 12 hours, it will suffer ischemic necrosis. Although about half of the patients with testicular torsion develop the condition after intense exercise, testicular torsion can also occur when the testicle is squeezed between the legs during side-sleeping, which is more pronounced than when standing and makes it easier to happen. Infants and adolescents who experience sudden swelling and severe pain in the scrotum during vigorous exercise or sleep should be suspected of testicular torsion and should seek medical attention promptly at a formal hospital's urology department. If diagnosed in time, manual reduction or emergency surgery can be attempted to preserve male characteristics and fertility to a large extent.