In a horrifying-but-true bit of news from China, an 11-year-old boy lost a testicle after it twisted 540-degrees, lost all blood flow and died. The technical term for the goddamn terrifying issue is testicular torsion and, according to the American Urological Association, it can happen after an injury to the scrotum or following strenuous exercise or even while you sleep.

Testicular torsion is a rare occurrence, affecting about 1 in every 4,000 males, and it’s far more likely to hit males who are around puberty or significantly older. It happens when the tissue surrounding the ball is weak and not fully adjoined to the scrotum, allowing the testicle to twist. As it rotates, it yanks the spermatic cord, a connected mass of fibers that supplies blood to your testicle. If the spermatic cord wraps around itself too many times, blood flow to the testicle ceases and the testicle dies in as short as two hours.

Such was the case with the 11-year-old Chinese boy, who was admitted to the hospital after walking with a painful limp for some time. Doctors in the Hangzhou hospital said the pain from his twisted testicle was generating immense pain. When they operated, they found—prepare to reflexively clamp your legs shut at this next bit—the testicle was so squeezed, it had burst open at the base slightly.

Dr. Chen Guangjie, from the Zhejiang University School of Medicine, reportedly informed the boy’s parents they had to remove the dead testicle and that the child’s odds of having children would likely be diminished as a result of this.

“Generally speaking,” Chen said, “Six hours after testicular torsion, patients lose the ability to produce sperm. If the angle of twist is 90-degrees, the testis will die in a week; at 180-degrees, the testis will die in three to four days. If it’s 360-degrees, 12 to 24 hours and if the spermatic cord twist exceeds 720-degrees, the testis will die within two hours.”