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Injury Prevention

Suffering In Silence Can Cost a Testicle: Teaching Boys To Speak Up About Testicular Pain

By Dr. Michael Leonard, Chief of Urology and Chief of Staff, Children’s Hospital of Eastern Ontario

The word ‘testicle’ doesn’t usually come up in everyday conversation, or in newspaper articles, for that matter. But as a urologist, I see suffering that could be prevented if we all could talk a little more freely about them. The issue is testicular torsion, when a testicle gets twisted and its blood supply is cut off. If the blood supply to the testicle gets cut off for too long, the testicle will die, and will have to be removed. If a boy with testicular torsion has surgery within 6-8 hours of noticing pain, we can usually save the testicle.

So getting treatment early is really important. But sometimes, boys are too shy to tell their parents that they are having pain, and don’t tell anyone until it’s too late. Some boys worry that they might have caused the problem by masturbating, but masturbating doesn’t cause testicular torsion. In the surgeries we do at CHEO (about one every 2 weeks), we are able to save the testicle in 2 out of 3 boys we see. If more boys got to the hospital within 6-8 hours of the pain starting, we would be able to save even more.

What causes testicular torsion? In some boys and men, the testicles are not well attached to the scrotum (the sac that holds the testicles), so they can twist more easily. But there is no way of knowing this ahead of time.

Testicular torsion starts off with severe pain in the testicle, which gradually gets worse. The pain can even wake a boy when he is sleeping. Sometimes the pain spreads into the lower abdomen on the same side. There may be swelling and redness of the scrotum. Some boys also have nausea and vomiting. Sometimes the pain goes away on its own, if the testicle ‘untwists’ itself. If this happens, it is still important to have your son checked, because there is a good chance that it could happen again.

What can parents do? Tell your sons and boys that you coach to make sure to tell a parent right away about any pain they have in the testicle. If your son has pain in the testicle for more than 30 minutes, bring him to CHEO’s Emergency Department to be checked. Remember, if your son does have testicular torsion, he will need surgery within 6-8 hours. If you live far from CHEO, you can bring your son to a hospital where there is a general surgeon or urologist on duty. Surgery is the best treatment for testicular torsion, so it’s best to bring your son straight to the hospital.

If you’d like more information on testicular torsion, check the American Urological Association’s website, at Follow the links to ‘Pediatric Conditions’ and then type ‘testicular torsion’ in the search box.


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