Testicular torsion is when a testicle twists inside the scrotum. This blocks blood flow to the testicle and can cause permanent damage if it's not treated right away. Know the signs and get help right away if they happen to you.

• Tell a parent or other adult if you have sudden or strong pain in a testicle or your groin. Talking about your testicles may be embarrassing, but ignoring pain or hoping it goes away can end in severe damage to the testicle.
• Go to an emergency room right away if you have signs of testicular torsion. If you get help fast, the testicle can be untwisted so that the damage is stopped.
• Even if the pain goes away on its own, you still need to see your health care provider.
• Know what to watch out for. The word "TWIST" can help you remember the signs and what to do:
  • T — Testicle or groin pain that is sudden.
  • W— Warning signs to act fast are pain, swelling, and/or redness in the scrotum.
  • I  —  Immediately tell a parent, school nurse, or other adult.
  • S — See a health care provider right away.
  • T — Time is limited.

• One testicle looks higher than the other, if this is unusual for you.

You have any signs of testicular torsion:

• testicle or groin pain that is strong or starts suddenly
• testicle or groin pain that goes away but comes back again
• a swollen, red, or painful scrotum

What causes it? Most of the time, there's no obvious reason why testicular torsion happens. It can happen at any time — after an injury, during exercise, or even while sleeping. It can happen at any age but is most common in teens. Because testicular torsion can't be prevented, it's important to know the signs and when to get help.

Why is it an emergency? Damage to the testicle happens fast. The longer the testicle stays twisted, the harder it is to save. Surgeons often can save a testicle if surgery is done within 4 to 6 hours after pain starts. But if you wait too long, doctors might need to remove the testicle.

What do health care providers do? At the emergency room, health care providers ask questions and do an exam. They might order a urine (pee) test and a painless test called an ultrasound to see blood flow to the testicles.

If there is a torsion, the surgeon will do an emergency operation to untwist the testicle and try to save it.