Testicular torsion in children, don't miss the golden time

Dr. Nguyen Phi Phong, head of the Department of Surgery at the Da Nang Obstetrics and Pediatrics Hospital, talks to children and their families about openness in sexeducation - Photo: DOAN NHAN

Many children with testicular torsion have vague pain and are afraid to talk about it. Parents need to be alert after 6 hours, the risk of necrosis increases, after 24 hours it is almost impossible to save.

Permanent loss of testicles

In the first 3 months of 2025, the Department of Surgery of Da Nang Obstetrics and Pediatrics Hospital received 5 cases of children with testicular torsion, most of whom had to have their testicles removed because they were admitted to the hospital too late.

A boy in Da Nang City was admitted to the hospital with a swollen scrotum and severe pain. Two days before, he had experienced a dull pain but was embarrassed to tell his parents, so he just endured it silently. When the pain became too much, the family took him to the Da Nang Obstetrics and Pediatrics Hospital, but it was too late to save the testicle.

Other children also showed signs of scrotal pain and abdominal pain one to two days before, but due to subjectivity, the family thought that this condition was not serious and could heal on its own. When the level of swelling and pain increased, the child was taken to the hospital.

Master, Doctor, CKII Nguyen Phi Phong, Head of Surgery Department, Da Nang Obstetrics and Pediatrics Hospital, said that testicular torsion is a surgical emergency. If not operated on promptly, the twisted testicle will become necrotic and must be removed. Worryingly, many children come to the hospital after the "golden time" to save the testicle has passed.

According to Dr. Phong, when the testicle is twisted, the blood vessels that nourish it are blocked, causing the testicle to become anemic and quickly become necrotic. The time that determines the survival of the testicle is very short. "Surgery within the first 6 hours can save the testicle up to 100%, from 6 to 12 hours this rate drops to 70%, from 12 to 24 hours it is only 20%. After 24 hours, the possibility of preserving the testicle is almost zero," Dr. Phong emphasized.

Testicular torsion can occur at any age, but is most common in infants and adolescents. Children with testicular torsion often have symptoms such as sudden severe pain in the scrotum, which may be accompanied by abdominal pain or pain in the groin on the same side. The scrotum is swollen, red, and touching the testicle makes the child more painful. In particular, many cases of pain start at night or early morning, which is an important sign for early diagnosis.

"Not all cases of scrotal pain are testicular torsion. However, if your child has signs of sudden pain and scrotal swelling that does not subside, take your child to a hospital with a pediatric surgery department for examination immediately. Do not hesitate day or night, because just a few hours of delay can cause your child to lose one testicle permanently," said Dr. Phong.

When a child is brought to the hospital with suspected testicular torsion, the doctor will perform a clinical examination and may order a Doppler ultrasound to assess blood flow. If testicular torsion is confirmed, surgery is the only treatment.

If the testicle is not necrotic, the doctor will untwist and fix it to prevent recurrence. If the testicle is necrotic and cannot be restored, it must be removed to prevent further necrosis. For children who have to have one testicle removed, the doctor will also fix the remaining testicle to prevent the risk of torsion in the future.

Sex education needed

MSc. Dr. Nguyen Dat Huy, Department of Surgery, Da Nang Obstetrics and Pediatrics Hospital, said that many boys, especially those in puberty, are often afraid to tell their parents when experiencing pain in the lower region. This makes the early signs of testicular torsion easy to miss.

In many cases, testicular torsion can present with atypical symptoms, such as abdominal pain accompanied by vomiting. When seeing a child with cramps in the lower abdomen, the family may mistake it for digestive problems, leading to delays in diagnosis and treatment.

"In the newborn stage, testicular torsion can occur in the fetus, making detection more difficult. Some children have scrotal swelling due to trauma, but their families subjectively think it is only an external impact and do not take their children for examination. Meanwhile, according to many studies, trauma can be a triggering factor, increasing the risk of testicular torsion. This subjective thinking can cause children to miss the time for early intervention, seriously affecting the ability to preserve the testicles," said Dr. Huy.

Teach children about genital health issues.

A worrying fact is that many teenage boys experience pain in the scrotum but do not dare tell their parents due to fear.

Dr. Phong recommends that parents should be more open in educating their children about sex, especially reproductive health. Teach children that there is nothing shameful about talking about health issues related to the genitals. If they feel pain or swelling in the scrotum, they should immediately notify an adult so that they can be taken to the doctor promptly.

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Source: https://tuoitre.vn/xoan-tinh-hoan-o-tre-dung-de-lo-thoi-gian-vang-20250410085057367.htm