Kiveskiertymä

Kiveskiertymä, also known as testicular torsion, is a medical emergency characterized by the twisting of the spermatic cord, which supplies blood to the testicle. This twisting cuts off the blood supply to the testicle, causing sudden, severe pain and swelling. It most commonly occurs in adolescents and young adults, but can happen at any age. The exact cause is not always clear, but it is often associated with a congenital anatomical variation where the testicle is not properly attached within the scrotum, allowing it to rotate freely. Trauma to the scrotum can also precipitate torsion in some cases.

Symptoms typically include a sudden onset of intense testicular pain, often on one side, which may radiate to the abdomen. Swelling of the scrotum is common, and the affected testicle may appear higher than the other and be positioned horizontally. Nausea and vomiting often accompany the pain. Prompt medical evaluation is crucial, as delaying treatment can lead to irreversible damage and loss of the testicle. Diagnosis is usually made based on clinical examination and confirmed with an ultrasound, which can assess blood flow to the testicle.

Treatment involves detorsing the spermatic cord, either manually or surgically. Surgical intervention is often necessary to untwist the cord and then secure the testicle in place (orcheopexy) to prevent future episodes. In cases where the testicle has sustained irreversible damage due to prolonged lack of blood flow, surgical removal of the testicle (orchiectomy) may be required. Early intervention, ideally within six hours of symptom onset, significantly improves the chances of saving the testicle.