Testicular Appendage Torsion

Testicular appendage torsion is the twisting of a small piece of tissue above a testicle. The appendage doesn’t have a function in the body. But it can twist and cause pain and swelling that gets worse over time. It's not the same as testicular torsion. It's not a medical emergency like testicular torsion.

Side view of testicle showing testicular appendage.Side view of testicle showing twisted testicular appendage.

What causes testicular appendage torsion?

Appendage torsion can happen at any time. It’s most likely to happen during sleep. And it's more likely in preteen boys. When the appendage gets twisted, it cuts off its own blood supply. This doesn’t cause any serious damage.

Is it the same as testicular torsion?

Testicular appendage torsion is not the same thing as testicular torsion. Testicular torsion is the twisting of the testicle. This is a medical emergency. The torsion causes a loss of blood supply to the testicle. Surgery is needed right away to prevent lifelong (permanent) damage. The symptoms can be similar in both conditions. But the pain of testicular torsion is often more severe.

Symptoms of testicular appendage torsion

Symptoms can include:

  • Pain in one testicle, on one side of the scrotum

  • Swelling and redness of the scrotum

  • Scrotum that’s sore to the touch

  • A hard lump at the top of the scrotum

  • A blue dot at the top of the scrotum, which shows that the twist is in the appendage, not the testicle

How is testicular appendage torsion diagnosed?

Your healthcare provider will ask about your health history and your symptoms. You’ll be given a physical exam. You may also have tests such as:

  • Urine test. This is to check for other possible causes of scrotal pain, such as infection.

  • Imaging test of your scrotum. This may include an ultrasound.

In some cases, you may need surgery right away if it seems like you may have testicular torsion. This is to help prevent severe problems. During surgery, the healthcare provider will be able to see if the condition is testicular appendage torsion.

Treatment for testicular appendage torsion

Treatment for testicular appendage torsion includes:

  • Rest

  • Raising the area to help ease swelling

  • Over-the-counter pain medicine

When to call your healthcare provider

Call your healthcare provider right away if you:

  • Have symptoms that don't get better, or that get worse

When to seek emergency medical care

Sudden testicular pain may be a medical emergency. See a healthcare provider and get checked right away.

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