Do no testicles mean no erection? (Testicular torsion)

Originally Published: April 19, 2002 - Last Updated / Reviewed On: April 29, 2015
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Dear Alice,

My friend had to have both of his testicles removed because of Testicular Torsion... will he be able to get an erection now?? What are the testicles for, anyway??

Dear Reader,

Testicular torsion is a painful condition that occurs when the spermatic cord — which includes the vas deferens, arteries, veins, lymphatics, and nerves — twists and cuts off blood supply to the testicle (where sperm and testosterone are produced). It happens when a small ligament that normally attaches a testicle's base to the scrotum becomes loose, allowing the testicle to twist and turn. A man could be born with a loose ligament, and so have some predisposition for this, but testicular torsion can also be the result of trauma to the scrotum or really strenuous physical activity.

Most often occurring in males under the age of 30 years, testicular torsion is more common during infancy or adolescence. It is estimated that the condition affects about 1 in 4,000 males under 25 years of age in the United States.

Symptoms of testicular torsion include:

  • Onset of sudden pain in a testicle
  • Swelling or tenderness of the scrotum
  • Nausea, vomiting, and/or fever
  • Abdominal pain
  • Fainting and light-headedness
  • Elevation of the testicle on the affected side

Testicular torsion requires surgery. In most cases, surgery needs to be performed as soon as possible after the onset of symptoms — preferably within six hours — in order to save the testicle. A restriction of blood flow due to testicular torsion could, over time, lead to the atrophying (shrinking) of the testicle, or even infection.

Having one testicle removed need not diminish or reduce sex drive or erections. But because the testicles produce male hormones, men who have lost both of their testes may experience a reduction in sex drive and difficulty in getting and/or maintaining an erection. When both testicles have been removed, the next step is usually testosterone replacement therapy, which can be discussed with one's primary health care provider or urologist.

Because the testicles produce sperm, losing both also means that a man can no longer have biological children. Your friend may want to talk with someone about how he feels about the surgery and its impact on his sex life and fertility.

Kudos to you for wanting to learn more about your friend's situation — he's lucky to have your support.


March 19, 2012

Hi, I too have lost both my testes! I was born with cryptochordism and both testes were undescended. Corrective surgery when i was 3 was successful on the right side but the left disappeared into...
Hi, I too have lost both my testes! I was born with cryptochordism and both testes were undescended. Corrective surgery when i was 3 was successful on the right side but the left disappeared into my abdomen. Doctors again tried to correct at 8 with no luck! It was decided to wait out puberty to remove the undescended teste and replace with a prosthesis. I was left with one nut that to my eyes never fully matured but the doctors were not worried! I started to experience pain when I was 36 in my right side and it was discovered after an ultrasound that I had microlithiasis in that teste. I ultimately had that one removed as it served no real purpose anymore, my testosterone count was hardly even on the chart. Normal is between 8?-30? Can't remember the units! And I was a 1! This explained my fatigue, loss of muscle mass, sex drive etc. I am now 38 I have been on testosterone replacement for almost 2 years and have never felt better! My erections are strong and super wife loves my new energy! And I am now able to grow a beard (strange) and build muscle. All I am trying to say is that life goes on! It is a hard blow to your ego at first but whether you have nuts or not does not define you as a man. I have 2 beautiful children, a loving over sexed wife and a new outlook on life. I wish I knew sooner that my life would change so drastically upon increasing my testosterone level. For any guy out there that is experiencing fatigue, lack of energy, depression, go and get your levels checked! Thanks for letting me tell my story! Rod