Medically reviewed by Mr Maneesh Ghei, Consultant Urological Surgeon (GMC: 5208045)

Testicular torsion is a serious and potentially urgent urological condition that occurs when a testicle rotates, twisting the spermatic cord and cutting off blood supply. It can develop suddenly, often without warning, and requires immediate medical attention. Knowing how to check yourself for testicular torsion and recognise the warning signs could be critical to preserving your health.

While testicular torsion is more common in teenagers and young men under 25, it can happen at any age. Understanding how to recognise the symptoms and perform a basic self-check can help you act quickly if something does not feel right.

What Is Testicular Torsion?

Testicular torsion happens when the testicle twists around the spermatic cord — the structure that supplies blood to the testicle. This twist restricts or cuts off the blood flow, which, if not treated quickly, may result in permanent damage or loss of the testicle.

While the condition is rare, it is considered a urological emergency. That is why it is essential to understand the signs and symptoms, particularly if you experience sudden discomfort in the scrotal area.

One of the key warning signs is scrotal swelling, often accompanied by intense pain, tenderness, or a noticeable change in the position of the testicle. The swelling may develop rapidly, causing the scrotum to appear red, inflamed, or enlarged on one side. In some cases, the affected testicle may sit higher than usual or feel firmer than normal.

Common Signs and Symptoms of Testicular Torsion

Testicular torsion typically develops rapidly, often beginning without warning and escalating within hours. Recognising the early signs is crucial, as prompt treatment may help prevent long-term damage. Symptoms can include:

• Sudden, severe pain in one testicle
• Swelling or tenderness in the scrotum
• A high-riding testicle or one that sits at an unusual angle
• Nausea and vomiting
• Discomfort in the lower abdomen
• Pain that may worsen over time or come and go

If you notice any of these symptoms, especially after physical activity or during sleep, do not delay. Contact a urologist or go to A&E as soon as possible.

How to Perform a Basic Self-Check for Testicular Torsion

While there is no substitute for a professional examination, you can check yourself for any unusual signs that could indicate a problem.

1. Choose the right time. The best time to check your testicles is after a warm shower or bath. The heat relaxes the scrotum, making it easier to notice changes.

2. Stand in front of a mirror. Look for any visible swelling, redness, or asymmetry. One testicle might naturally hang lower than the other, but if there is a sudden shift or bulge, that may signal a concern.

3. Use your fingers gently. Using both hands, roll each testicle between your thumb and fingers. Feel for any lumps or firm areas, a noticeable difference in size or shape, sensitivity or pain during the examination, and unusual firmness or hardness.

4. Assess the cord and position. The spermatic cord should feel like a soft tube running up from the top of each testicle. If one testicle feels like it is twisted or elevated, it may suggest torsion.

5. Take note of scrotal swelling. Swelling in the scrotum may be due to several causes. If you notice scrotal swelling combined with pain or tenderness, do not wait to get it checked by a healthcare professional.

What to Do If You Suspect Testicular Torsion

If you believe you are experiencing symptoms of testicular torsion, treat it as a medical emergency. Surgical intervention is typically required to untwist the spermatic cord and restore blood flow.

Delaying medical help for more than six hours may result in irreversible damage. If you have access to a private urologist, same-day or next-day assessment may be available, helping you avoid long waits when speed matters most.

If you are in London and looking for specialist urology advice, Mr Maneesh Ghei offers private consultations at The Wellington Hospital, St John’s Wood. No GP referral is required and same-week appointments are usually available.

Preventive Awareness

While testicular torsion cannot always be prevented — particularly in individuals with a condition called bell clapper deformity, where the testicles are more prone to twisting — being informed about your body can help you detect changes early.

Consider speaking to a urologist if you experience recurring testicular discomfort, notice changes in the position or feel of your testicles, have a family history of testicular torsion, or simply want reassurance through a routine check-up.

Frequently Asked Questions

What does testicular torsion feel like?

The most prominent symptom is sudden, severe pain in one testicle. This can come on rapidly, sometimes during sleep or after physical activity. The affected testicle may also appear higher than usual, and the scrotum may swell and become tender. Nausea and lower abdominal discomfort are also common.

How quickly does testicular torsion cause damage?

Blood flow is cut off quickly once the testicle twists. Research suggests that the chance of saving the testicle is over 90% if surgery is performed within six hours, but drops significantly after that. Beyond 24 hours, the damage is often irreversible. This is why testicular torsion must always be treated as an emergency.

Can testicular torsion resolve on its own?

No. Testicular torsion does not resolve without treatment. The twisted spermatic cord must be manually untwisted and surgically secured to prevent it happening again. Do not wait to see if the pain improves on its own — seek medical attention immediately.

How is testicular torsion diagnosed?

Diagnosis is usually made through a physical examination and an ultrasound scan, which can assess blood flow to the testicle. In cases where torsion is strongly suspected and the clinical picture is clear, surgeons may proceed to surgery without delay rather than waiting for scan results, as time is critical.

What is the treatment for testicular torsion?

Treatment is surgical. A procedure called orchidopexy is performed to untwist the spermatic cord and secure both testicles to prevent future torsion. If the testicle has been without blood supply for too long and cannot be saved, removal (orchidectomy) may be necessary. Prompt surgery gives the best chance of a full recovery.

Can testicular torsion happen more than once?

If testicular torsion is treated surgically, both testicles are typically secured during the procedure to prevent recurrence. Without surgical fixation, there is a risk of the same testicle twisting again. If you have had testicular torsion in the past and did not have surgery, speak to a urologist about your risk.

Where can I see a private urologist in London?

Mr Maneesh Ghei is a consultant urological surgeon based at The Wellington Hospital, Platinum Medical Centre, St John’s Wood, London NW8 7JA. He covers kidney infections, kidney stones, urinary problems, and a wide range of urological conditions. Same-week appointments are available with no GP referral needed.

About the Author

Mr Maneesh Ghei, Consultant Urological Surgeon (GMC: 5208045)

Mr Maneesh Ghei is a consultant urological surgeon with NHS and private practice across four London hospitals. He specialises in the diagnosis and management of kidney infections, urinary tract conditions, kidney stones, prostate conditions, and male sexual health. Mr Ghei sees new patients privately with same-week availability. No GP referral is required. Book a private urology consultation.