a doctor examining a case of testicular torsion

Testicular Torsion: Making Motherhood into a Nut Job

Editor's note: The names of people and locations in this article have been withheld to protect medical information. We greatly appreciate this Special Contributor submission.

I once cruised through motherhood believing "nuts and bolts" were my husband’s department while training bra shopping was mine. Other than knowing little boy things required protection during sports, I was blissfully ignorant about testicles—until last summer.

Knee-deep in half-painted canvases, disassembled picture frames, and card stock, I was scrambling to convert my craft room into a guest bedroom for my sister-in-law’s arrival from Ohio. She texted me her ETA: four hours away. A four-hour window is a curious thing, for it was just enough time to pull together my image of being a Pinterest-perfect house wife and just barely enough time to save my son’s testicle from dying.

"The less-than-perfectly-clean house became trivial and I began praying prayers like, 'Please God, save his testicle!'"

I was all nerves racing to beat the clock and running on just a few hours of sleep because I just had to paint a bookcase the night before. Then my son waded through my trail of trash bags and other things-to-be-donated complaining of his rib cage feeling like it was in a tug-of-war battle with his “peanut” (testicle), and his rib cage seemed to be winning.

No pediatrician ever warned me about testicle scenarios, and I had never heard or read much about them. He winced when I touched his abdomen and his right testical hung slightly higher than the left which seemed abnormal, but I knew breasts weren’t perfectly symmetrical. I questioned whether testicals were similar in how they hang. I had never noticed or questioned until then.

My little guy had only been cleaning his room; he hadn’t been tackled, punched, or kicked. He wasn't doubled over, seeing stars, or talking in a high-pitched voice like what is portrayed on TV. I examined him for appendicitis but found no red flags. Nothing alerted me to the danger looming over my son or my prospects for future grandbabies. 

Assuming he must have pulled something while running down the stairs, I told him to take it easy and sent him back up to clear his Lego table. My plan was to watch him and if he complained again I’d give him acetaminophen and make him rest on the couch. At this point, I certainly wasn’t considering a trip to the ER nor surgery as a necessary plan of action.

His dad was lunching with a friend who is a physician; I texted him and left it to his discretion whether to mention it or not. Twenty minutes later, the guest bedroom was clean and the guys were on their way over to rule out the possibility of a testicular torsion, a twisted testicle. Okay, whatever. I thought their concern seemed like a case of male camaraderie. Was a sore “peanut” really that big of a deal or was it just men taking something seriously because male parts were involved? Was a house call warranted?

When they arrived and my son bounced down the stairs as usual I felt like the overreactive mother who called the doctor for nothing. But a few minutes later, we were on our way to the hospital for an ultrasound to confirm testicular torsion, a condition occurring when the spermatic cord becomes twisted and vital blood supply to the testicle is lost. The less-than-perfectly-clean house became trivial and I began praying prayers like, “Please God, save his testicle!”

"When medical attention is sought within six hours of pain onset, the testicle is preserved in nearly 100% of cases; unfortunately, most patients miss this short window of time."

Common symptoms of testicular torsion are pain and swelling on the affected side. Symptoms may or may not seem alarming initially, but without treatment the testicle dies within hours of pain onset and must be surgically removed. When medical attention is sought within six hours of pain onset, the testicle is preserved in nearly 100% of cases; unfortunately, most patients miss this short window of time.  When treatment is delayed for twelve hours or more the success rate drops to only 20%. 

Fortunately for my son, we were encouraged to visit the ER by our family friend and able to find a urologist whose practice addresses both adult and pediatric issues. He dropped his afternoon agenda to perform the emergency surgery for my son in what would be the doctor's second torsion case in two weeks.

The psychological effects of losing a testicle can be devastating. When my son woke up in post-op, the first real thing he said was, “Mom, is my peanut still there?” I confirmed, but he wanted proof. I discreetly raised the blanket and his hospital gown and snapped a pic. He smiled with relief, hugged his stuffed shark, and contentedly returned to his power nap while his cousins ate pizza and swam at our house.

Pediatricians are not warning moms about torsions even though we are most often the one making the call on whether to go to the ER. I haven’t met one mother yet who already knew of them before my mention of the topic. Moms, ask your pediatricians about torsions because nuts and bolts are our business too, and who knows—your grandkids may thank you someday. 

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