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I have been conducting extensive research over the last few years on the history of nudity in social situations, and I am looking to expand my research base now I have come across a few other interesting facts.

I have asked a similar question on the Psychology & Neuroscience Stack for any psychological benefits and adverse effects from social nudity and what I am after overall is...

Are there any physical health effects of social nudity (benefits and adverse effects).

For this particular question, I am asking...

Does anyone know of anything which would scientifically support or refute a claim that nudity would help prevent Testicular Torsion?

I found prevention of testicular torsion being given as a reason for not wearing underpants interesting so I did a little research on this, although I am not even sure how "going commando" would make a difference when wearing clothing, unless the underpants were tight. Surely wearing loose fitting underwear would have the same effect as going commando in other clothing.

Testicular Torsion occurs when the spermatic cord to a testicle twists, cutting off the blood supply (a condition called ischemia). The most common symptom is the rapid onset of acute testicular pain and prolonged testicular torsion will result in the death of the testicle and surrounding tissues.

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Testicular torsion occurs when the spermatic cord to a testicle twists, cutting off the blood supply (a condition called ischemia). The most common symptom is the rapid onset of acute testicular pain and prolonged testicular torsion will result in the death of the testicle and surrounding tissues (Ogunyemi, et al. 2018).

Generally, testicular torsion requires emergency surgery. If treated within a few hours, the testicle can usually be saved. However, waiting longer for treatment can cause permanent damage and may affect the ability to father children. When blood flow has been cut off for too long, a testicle may become so badly damaged it has to be removed.

Wearing underpants will not necessarily prevent testicular torsion. Males who get testicular torsion have an inherited trait that allows the testicle to rotate freely inside the scrotum. This inherited condition often affects both testicles (Mayo Clinic, 2018).

In men and boys who are at risk of testicular torsion, the condition often occurs with no apparent trigger. Testicular torsion often occurs several hours after vigorous activity, after a minor injury to the testicles or while sleeping. Cold temperature or rapid growth of the testicle during puberty also might play a role.

The risk factors are:

  • Age
    Testicular torsion is most common in males between 10 and 25 years old.
  • Previous testicular torsion
    A person that had testicular torsion that went away without treatment is likely to have it again in either testicle unless surgery is performed to correct the underlying problem.
  • Climate
    Torsions are sometimes called "winter syndrome". This is because they often happen in winter, when it is cold outside. The scrotum of a man who has been lying in a warm bed is relaxed. When he arises, his scrotum is exposed to the colder room air. If the spermatic cord is twisted while the scrotum is loose, the sudden contraction that results from the abrupt temperature change can trap the testicle in that position. The result is a testicular torsion.
  • Bell clapper deformity
    In this deformity the testicle is only attached to the spermatic cord, like a bell clapper. A bell clapper deformity is a predisposing factor for testicular torsion in non-neonates. Currently there is no recommended clinical examination for a bell clapper deformity.

    Having testicles that can rotate or move back and forth freely in the scrotum is an inherited trait. Some males have this attribute and others do not. The only way to prevent testicular torsion for a man with this trait is through surgery to attach both testicles to the inside of the scrotum so that they cannot rotate freely. (Brunner, 2010)

With these facts in mind, with exception of a slight plausability created through the climate issue, neither being clothed or practicing nudism/naturism (whichever you wish to call it) can prevent testicular torsion.

Other aspects aside from testicular torsion

With regards to protection from urine, semen and faeces, with good personal hygiene, these won’t pose a problem. The combination of heat, sweat, and friction in your nether regions is not only uncomfortable, it can be unhealthy. Tight and non-breathable clothing traps heat and moisture, which can encourage the growth of candida, and lead to an unbearable yeast infection. That's not the only thing you have to worry about. When bacteria travel from back to front, it increases your risk for contracting an uncomfortable urinary tract infection (UTI) as well.

For men, the temperature of the testes is at issue: In order for testes to produce sufficient quality and quantity of sperm, the temperature of testes must be lower than the core body temperature.

"That is why [testes] are located outside of the body," explains Celia E. Dominguez, reproductive endocrinologist, Centre for Reproductive Medicine at the Emory University School of Medicine. "Testes were made to be out in the breeze." (Davis, 2004)

Testes can overheat when a man wears brief underwear. If the testes are too hot — several degrees above where they should be — they are not able to produce sufficient sperm, resulting in low sperm count.

References

Brunner, S. (2010). What Is Testicular Torsion? What Causes Testicular Torsion? Medical News Today [Online]
Retrieved from: http://www.medicalnewstoday.com/articles/190514.php

Davis, J. L. (2004). Boxers vs. Briefs: Increasing Sperm Count. WebMD [Online]
Retrieved from: http://www.webmd.com/infertility-and-reproduction/features/boxers-vs-briefs-increasing-sperm-count

Mayo Clinic. (2018). Testicular Torsion, Mayo Clinic [Online]
Retrieved from: https://www.mayoclinic.org/diseases-conditions/testicular-torsion/symptoms-causes/syc-20378270

Ogunyemi, O. I., Weiker, M., & Abel, E. J. (2018). Testicular Torsion, Medscape [Online]
Retrieved from: https://emedicine.medscape.com/article/2036003-overview#showall

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From the (almost nonexistent) research I could find related to the presence of underwear and concomitant testicular torsion, I think that loose underwear or complete nudity would actually increase your risk of testicular torsion, as the testicles are more mobile without restriction by a form-fitting garment. The only resource I can find supporting your original claim is an answer on Quora, which I would not necessarily trust.

"Diagnosis and Management of Testicular Torsion, Torsion of the Appendix Testis, and Epididymitis." Shan Yin, Jennifer L. Trainor. Clinical Pediatric Emergency Medicine. 2009.

In addition, scrotal support with a pediatric athletic supporter or tight-fitting brief-style underwear can minimize mobility of the testicle and hence pain.

Although this doesn't specifically mention loose-fitting underwear as a potential risk factor for testicular torsion, I don't think it's an unreasonable inference to draw, especially given corroborating research in adolescent athletes:

"Testicular Health Awareness in Pubertal Males." Phillip Nasrallah, Giju Nair, Joseph Congeni, Cynthia L. Bennett, Daniel McMahon. The Journal of Urology. 2000.

...5% of athletes reported tight underwear or compression shorts as their only type of protection [against testicular torsion].

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    Your quote for Nasrallah, et al. (2000) (as far as I can see from reading the full article) does not relate specifically to testicular torsion, but any testicular injury from contact sports. As for Yin and Trainor (2009), the full quote is "Patients with torsion of the testicular appendage can be treated supportively once testicular torsion has been excluded. Nonsteroidal antiinflammatory drugs are recommended, as well as limitation of activity to minimize pain." <then add your quote>. To me, you have not provided evidence to support the idea that nudity would increase the risk – Chris Rogers Oct 17 '18 at 13:21
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    Also, after re-reading my answer (sleepily written last night), it appears that I acknowledged your exact criticism and then hedged it with the second reference, which you didn’t mention. – Bruce Kirkpatrick Oct 17 '18 at 13:53
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    I can see your point about movement causing pain after injury, Bruce, and it is a valid point. However, the question is whether underwear actually prevents, or can be a cause of testicular torsion; not whether it can help with pain management when there is scrotal/testicular injury. As for your second reference you mentioned in your last comment, I mentioned both reputable references. As for Quora, I agree that you cannot always rely on information there which is why this site is better (we insist on reputable sources of info.) – Chris Rogers Oct 17 '18 at 14:00
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    As it happens, I did some research on this a while back and forgot to post it up. I have now added it as an answer – Chris Rogers Oct 17 '18 at 14:25
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    Perfect! It’s an excellent answer. – Bruce Kirkpatrick Oct 17 '18 at 14:34

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