What is testicular torsion? The condition behind Tilak Varma's surgery

Following Tilak Varma's surgery, experts break down how testicular torsion occurs, why time is critical and what recovery usually involves

The recent news of cricketer Tilak Varma undergoing emergency surgery left fans concerned and curious. The diagnosis, testicular torsion, is a medical emergency that requires immediate treatment to prevent permanent damage.

 

What is testicular torsion?

 

Testicular torsion occurs when the testicle twists around the spermatic cord, the structure that supplies blood to the testis. This twist cuts off blood flow, causing severe pain and rapid damage.

 

According to Dr Prasanta Kumar Nayak, Clinical Head & Fertility Specialist at Oasis Fertility, “Testicular torsion is a time-sensitive emergency. If blood supply is not restored within six hours, the testicle may not survive.”

 

 

While it is more common in adolescents, torsion can occur at any age, including adulthood, as seen in Tilak Varma’s case.

 

The onset is usually sudden and intense. Common warning signs include:

 

• Severe pain in one testicle
• Swelling or redness of the scrotum, testicle
• Lower abdominal pain
• Nausea or vomiting
• One testicle appearing higher than the other

 

Doctors stress that pain which does not ease should never be ignored or treated with home remedies.

 

Why does testicular torsion happen?

 

In many cases, torsion occurs due to a congenital condition called the bell-clapper deformity, where the testicle is not firmly attached inside the scrotum, allowing it to rotate freely. It may also happen after strenuous physical activity, minor trauma, or even while someone is sleeping. For athletes, the risk is especially high, as testicular torsion can occur after sudden twisting movements, sprinting or contact injuries.

 

Dr Thichen Kalden Lama, Head of Department – Paediatric Surgery, Manipal Hospital, Delhi, explains that torsion is often unpredictable, which is why awareness is crucial. Early presentation to a hospital makes all the difference.

 

Any delay in treatment may lead not only to loss of the testicle but also long-term hormonal and reproductive effects, which can impact performance, recovery and mental well-being, say our experts.

 

How is testicular torsion diagnosed?

 

Diagnosis is primarily clinical, based on symptoms and physical examination. Doctors often use an ultrasound to see if blood is reaching the testicles. However, they warn that tests should not delay surgery when testicular torsion is strongly suspected, as time is critical.

 

“When torsion is suspected, surgical exploration should not be postponed for extensive testing,” Dr Lama notes.

 

Treatment: Why is surgery urgent?

 

The only definitive treatment is emergency surgery. During the procedure, doctors untwist the affected testicle and secure it in place to prevent recurrence. The other testicle is usually fixed as well, as a preventive measure.

 

If blood flow is restored in time, the testicle can be saved. However, if surgery is delayed beyond 6–12 hours, the tissue may become non-viable, and removal may be necessary.

 

Recovery and fertility concerns

 

Recovery typically takes a few weeks, during which some swelling, tenderness and bruising are normal. Patients are advised to avoid heavy physical exertion and sexual activity for a short time. During surgery, doctors often fix the other testicle in place as a precaution to reduce the risk of future torsion.

 

A major worry among patients is whether testicular torsion affects fertility. Dr Nayak reassures that timely treatment often preserves reproductive potential.

 

“If torsion is corrected early and the testis is viable, most men retain normal fertility,” he says. “Even if one testicle is lost, the remaining testis can usually maintain hormone levels and sperm production.”

 

“If you’ve experienced testicular torsion, consider fertility testing three to six months after recovery,” Dr Nayak advises.     

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This report is for informational purposes only and is not a substitute for professional medical advice.