Tilak Varma's testicular torsion surgery: What is it, risks, early signs and more explained by doctor | Today News

Indian batter Tilak Varma made headlines when he announced the news of his testicular torsion surgery. He underwent an emergency surgery on Thursday for a groin issue that triggered acute pain, as per the news agency PTI. Although he is currently stable and recuperating, Tilak will miss the first three T20Is of the upcoming multi-format white-ball series against New Zealand.

In simple terms, he explained, “It is a urological equivalent of stroke or myocardial infarction. This ischemic event initiates a rapid cascade of hypoxia, cellular edema and irreversible germ-cell injury. Unlike the other inflammatory or infectious conditions of the testis and scrotum, testicular torsion is time-dependent, not symptom-dependent.”

Testicular viability drops quickly once the blood supply is cut off. Hence, within the first 4–6 hours, the chances of saving the testis are still high, making it the “golden window.”

“At 12 hours, the likelihood of testicular survival is poor; beyond 24 hours, necrosis is almost universal. Hence, this 4-6 hour period is considered the golden hour to salvage the testis,” Dr Prakash explained the urgency of an emergency surgery in the case.

When testicular torsion is suspected clinically, urgent surgical exploration is mandatory.

The doctor asserted, “It is not optional, not conditional, and should not be delayed for imaging if it risks time loss. It is very important not to compromise the golden hour.”

"Tilak Varma reported acute Testicular Pain in Rajkot, where he is part of the Hyderabad team for the Vijay Hazare tournament. He was taken to Gokul Hospital and on scan was diagnosed with Testicular Torsion (sudden, intense pain) and was advised immediate surgery," a BCCI official told PTI.

“For athletes, the stakes are particularly high because torsion frequently follows sudden rotational movements, sprinting, or contact trauma. Delay in treatment risks not only testicular loss but long-term hormonal and reproductive consequences, directly impacting performance, recovery, and psychological well-being of the athlete,” added Dr Prakash.

Testicular torsion is trending following Tilak's health crisis. Although it is an uncommon but important condition, it shows a clear bimodal age pattern.

According to Dr Prakash, testicular torsion mostly affects newborns within the first month of life, usually due to extravaginal torsion. However, adolescents between 12 and 18 years are regarded as the most commonly affected age group.

“Testicular torsion is most common among 12 and 18 years, correlating with rapid testicular growth at puberty. Although it can occur after this age, the incidence is less.”

“The documented incidence is approximately 1 in 4,000 males under 25 per year. Peak risk is during puberty due to increased testicular volume and hyperactive cremasteric reflexes, predisposing anatomy such as the bell-clapper deformity is present in up to 90% of cases and it is frequently bilateral.”

Dr Prakash advises that one must look out for early signs of testicular torsion.

“The commonly overlooked features are sudden-onset lower abdominal or inguinal pain without initial scrotal localisation, nausea and vomiting disproportionate to abdominal findings, a vague “pulling” or “twisting” sensation in the groin and a transient pain that briefly settles (partial torsion), falsely reassuring both patient and clinician.”

Unfortunately, such cases are often misdiagnosed as gastroenteritis, appendicitis, renal colic, or muscular strain, as per the expert.

Note to readers: This article is for informational purposes only and not a substitute for medical advice.