Testicular torsion describes the twisting of the spermatic cord resulting in testicular ischaemia and necrosis. It most commonly seen in males aged between 10 and 30 (peak incidence 13-15 years).


  • Incidence: 100.00 cases per 100,000 person-years
  • Peak incidence: 20-30 years
Condition Relative
Testicular torsion1
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Clinical features

  • pain is usually severe and of sudden onset
  • the pain may be referred to the lower abdomen
  • nausea and vomiting may be present
  • on examination there is usually a swollen, tender testis retracted upwards. The skin may be reddened
  • cremasteric reflex is lost and elevation of the testis does not ease the pain


  • treatment is with surgical exploration. If a torted testis is identified then both testis should be fixed as the condition of bell clapper testis is often bilateral.