¶ … pathophysiology: Testicular torsion "Testicular torsion occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum. The reduced blood flow causes sudden and often severe pain and swelling. Testicular torsion is most common between ages 12 and 16, but it can occur at any age, even before birth" (Testicular torsion, 2014, Mayo Clinic). Visually, it presents itself as a testicle which is positioned unusually higher than the opposite testicle. The condition can be extremely dangerous. "If the testicle rotates several times, blood flow to it can be entirely blocked, causing damage more quickly" (Testicular torsion, 2014, Mayo Clinic). Some males have testicles which are more prone to rotation, causing a greater likelihood of manifesting torsion. Rapid growth of the testes during puberty is a contributing factor, however, and thus the condition may be present even in young males without the genetic tendency...

"All prepubertal and young adult males with acute scrotal pain should be considered to have testicular torsion until proven otherwise. The finding of an ipsilateral absent cremasteric reflex is the most accurate sign of testicular torsion. Torsion of the appendix testis is more common in children than testicular torsion and may be diagnosed by the 'blue dot sign'" (i.e., tender nodule with blue discoloration on the upper pole of the testis)" (Ringdahl & Teague 2014). Torsion is rarely caused by trauma and is most common in adolescent males whose testes have increased in volume rapidly (such as due to puberty). "Torsion initially obstructs venous return. Subsequent equalization of venous and arterial pressures compromises arterial flow, resulting in testicular ischemia" (Ringdahl…