Is There a Relationship Between Waking Up from Sleep and the Onset of Testicular Torsion?

Abstract

Meshari A Alzahrani,1 Mishal M Alasmari,2 Moataz I Altokhais,3 Fawaz W Alkeraithe,4 Talal A Alghamdi,4 Abdulaziz S Aldaham,5 Alwaleed H Hakami,6 Saud Alomair,7 Basel O Hakami8 1Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia; 2College of Medicine, King Khalid University, Abha, Saudi Arabia; 3Department of Urology, King Khalid University Hospital, Riyadh, Saudi Arabia; 4Department of Urology, King Fahad Medical City, Riyadh, Saudi Arabia; 5College of Medicine, Jouf University, Al Gurayat, Saudi Arabia; 6College of Medicine and Surgery, Jazan University, Jazan, Saudi Arabia; 7College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia; 8Department of Urology, King Faisal Medical City for Southern Region (KFMC), Abha, Saudi ArabiaCorrespondence: Meshari A Alzahrani, Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, 11952, Saudi Arabia, Tel [phone], Fax [phone], Email [email protected]: Testicular torsion is a serious urologic emergency that can present with unusual or atypical history and examination. Classical pain from testicular torsion is of sudden onset, significantly severe, and is accompanied by nausea and vomiting. However, in some patients, the initial scrotal pain appears to considerably subside within the next few hours. In others, testicular torsion tends to occur while sleeping, and many patients recount a history of being woken up from sleep by intense pain. Furthermore, some patients in this subset can resume normal activities and even sleep through the night with little or no discomfort, without a perceived need for pain medications. Other patients initially experience mild pain, which worsens over time. Consequently, these patients are less likely to be evaluated immediately. In view of these atypical cases, the question remains unanswered regarding sleep as a predisposing factor for testicular torsion. This narrative review focuses on exploring the association between sleep and testicular torsion.Keywords: testicular torsion, torsion of the spermatic cord, acute scrotum, sleep, sleeping, literature review

Keywords

• testicular torsion
• torsion of the spermatic cord
• acute scrotum
• sleep
• sleeping
• literature review.