In men, it is possible for the sac to become twisted, gangrenous and painful. Sudden onset of severe testicular pain and tenderness occurs. Torsion of the testis is a surgical emergency that requires treatment within a few hours and also has the same symptoms. The diagnosis is only made during surgery, after ensuring that the testis itself has not become twisted and gangrenous. During the operation the offending piece of tissue is removed, with no subsequent adverse effects upon the potency or masculinity of the patient. Recovery is usually complete within three or four days.