Justin Bieber's swollen testicle drama has raised an important men's health issue

According to TMZ, back in May, Justin Bieber allegedly suffered a testicular injury after playing soccer and checked himself into a hospital. The 23-year-old pop star had “WebMD'd himself into a tizzy" and diagnosed himself with testicular torsion, even though the doctor who examined Bieber found that all he had was some swelling in the testicular area. This week, an employee at the hospital where Bieber was a patient filed a wrongful termination lawsuit against her former employer. While the hospital claims she leaked his medical files, she alleges that she did not leak the files and that she was instead fired due to her gender. (We have reached out to Bieber's team and will update if we hear back.)

Legal issues aside, if you came across this story and went, "wait, what's a testicular torsion?," you’re not alone — we did, too. While Bieber was not ultimately diagnosed with the condition, and was instead diagnosed with less serious testicular swelling, it is true is that testicular torsion is a somewhat common issue. So we called a few doctors to see what it's all about and how to avoid it happening to you.

"Testicular torsion is caused when the spermatic cord that attaches the testicle to the body becomes twisted and cuts off the flow of blood to the testicle,"Michael P. Zahalsky, MD, who specializes in Urology and is the founder of Z Urology in Coral Springs, Florida, explained. He likened it to what happens when you pick an apple: "To pick the apple you need to twist the stem until the apple comes off. That can happen with testicular torsion — it's twisted until the testicle dies."

A testicular torsion can also happen when a man is running or bicycling, and his testicles are flapping around so much that they twist up. It can also happen if you're playing sports and take a ball to the groin. "But the most common way it happens is just a random and spontaneous a movement you make, perhaps while working out or playing sports or during sex," says Jamin V. Brahmbhatt, MD, who specializes in urology at Orlando Health.

It can also happen while you sleep. Yes, seriously. One Chinese boy lost a testicle in just such a manner.

That said, Dr. Zahalsky says testicular torsion is more common among guys in their early teens. In males younger than 25 years old, the incidence of torsion is approximately 1 in 4,000. "Sometimes little kids will play with [their balls] and twist them and it can happen that way," he said. (Hopefully you've grown out of that by now, but if you haven't: Stop it. Stop it now.)

If you do experience pain or swelling in the testes, don’t ignore it. "If you have pain that lasts longer than 15 minutes, go to the emergency room. If the pain gets worse, go to the ER. If your balls are getting larger, go to the ER. When in doubt, just go to the ER. There's about a four-hour window before it can be in real danger," says Dr. Brahmbhatt.

In a typical case, the doctor will be able to manually untwist the testicles. But "the danger with intermittenttorsions is if you don't get it treated, your body could create anti-sperm antibodies that can affect your fertility," says Zahalsky.

For athletes, the best way to avoid them altogether is to wear tight-fitting bike shorts or underwear while working out. "You want to wear something that will stop the bounce," says Zahalsky.

Of course, as Bieber reportedly learned firsthand, there are other reasons for testicular pain or swelling that don't have to do with testicular torsion. If you get hit in the groin, for instance, that can often lead to swelling.

But swollen or painful balls can also signify an infection like gonorrhea and chlamydia. So if you do experience any sudden swelling or pain, play it safe and see a doctor. And if you still have further questions about your testicles, check out our Men's Health user manual for your balls. Because while our embarrassing hospital visits might not make the national news, they can be pretty humiliating nonetheless.