Does testicular torsion affect fertility?
Bell clapper deformity
What causes bell clapper deformity?
Is bell clapper deformity genetic?
How many people have bell clapper deformity?
How do you know if your testicle is twisted?
Does testicular torsion affect fertility?
The effect of testicular torsion on long-term fertility is related to the age at which it occurs. Prepubertal torsion does not affect the contralateral testicular development or result in abnormal semen. Normally, testicles move from the lower belly into the scrotum the pouch of skin below the penis in the last few months before birth. But sometimes, one or both do not fall into place. This is called an undescended testicle, and it can affect fertility later in life.
To make healthy sperm, testicles need to stay a few degrees cooler than the rest of the body. That’s why they normally rest in the scrotum, which hangs just far enough down that it’s not quite as warm.
An undescended testicle stays up in the body, so it has a higher temperature. That causes a lower sperm count and quality, decreasing a man’s chances of being able to fertilize a woman’s egg and father a child.
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Bell clapper deformity
In most males, a testicle would not be able to twist because it is firmly attached to the scrotum. For a male who is born with bell clapper deformity, his testes are hanging in the scrotum and can swing freely, like a clapper in a bell. This can then lead to twisting. This deformity affects both testes, although it is very rare for twisting, or torsion, to occur in both sides of the scrotum at once.
What causes bell clapper deformity?
Many of those who have testicular torsion are born with a higher risk for the condition, although they may not know it.
Congenital factors
Normally, the testicles can’t move freely inside the scrotum. The surrounding tissue is strong and supportive. Those who experience torsion sometimes have weaker connective tissue in the scrotum.
In some instances, this may be caused by a congenital trait known as a “bell clapper” deformity. If you have a bell clapper deformity, your testicles can move more freely in the scrotum. This movement increases the risk of the spermatic cord becoming twisted. This deformity accounts for 90 percent of testicular torsion cases.
Testicular torsion can run in families, affecting multiple generations as well as siblings. The factors contributing to a higher risk aren’t known, though a bell clapper deformity may contribute. Knowing that others in your family have experienced testicular torsion can help you request emergency treatment immediately if its symptoms affect you or someone in your family.
Not everyone who experiences this condition has a genetic predisposition to it, however. Approximately 10 percent of those with testicular torsion have a family history of the condition, according to one small study.
Other causes
The condition can occur at any time, even before birth. Testicular torsion can occur when you’re sleeping or engaging in physical activity.
It can also occur after an injury to the groin, such as a sports injury.
Rapid growth of the testicles during puberty may also cause the condition.
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Is bell clapper deformity genetic?
Most cases of testicular torsion are in males who have a genetic condition called the bell clapper deformity. Torsion can happen to boys and men of any age, but is most common in 12- to 18-year-olds. It can happen after strenuous exercise, while someone is sleeping, or after an injury to the scrotum.
about 4-8% of cases are the result of trauma. There is thought to be a possible genetic basis for predisposition to torsion, based on multiple published reports of familial testicular torsion. There is controversy whether cold weather months are associated with an increased risk.
How many people have bell clapper deformity?
This congenital abnormality is present in approximately 12% of males and is bilateral in 40% of cases. It is most common just after birth and during puberty. It occurs in about 1 in 4,000 to 1 in 25,000 males under 25 years of age each year. Of children with testicular pain of rapid onset, testicular torsion is the cause of about 10% of cases.
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How do you know if your testicle is twisted?
An individual who experiences testicular torsion may have:
- Sudden or severe pain in one testicle
- Swelling of the scrotum, the loose bag of skin under the penis that contains the testicles
- Lumps in the scrotum
- Nausea
- Blood in the semen
- Vomiting
- Abdominal pain
The man may also notice that one testicle is positioned higher than normal or at an odd angle. The affected testicle may become larger, and it may become red or dark in color.
Symptoms usually appear suddenly, although in some cases, the torsion can develop over a few days.
It is important to seek emergency care for sudden or severe testicle pain. The signs and symptoms may be caused by another condition, but prompt treatment can prevent severe damage or loss of the testicle if it is testicular torsion.
If there is sudden testicle pain that goes away without treatment, it may be that a testicle has twisted and then untwisted without intervention. This is known as intermittent torsion and detorsion.
Even if the testicle untwists on its own, it is important to seek prompt medical help, because surgery may be needed to prevent the problem from happening again.