Context Testicular torsion, the twisting of the testis or spermatic cord, places the testis at risk of vascular compromise and is a surgical emergency. Testicular torsion is predominantly unilateral (98% of torsion cases) and primarily affects neonates and adolescents in a bimodal distribution. Bilateral testicular torsion is exceedingly rare (2% of cases) and is associated with neonates. To the authors’ best knowledge, there have been no reports of bilateral torsion in adult males over the age of 24. Case details A 57‐year‐old man presented to the emergency department 9 days after developing testicular pain while lifting his lawnmower. Ultrasonography performed at an outside facility was unremarkable. He was encouraged to followup with urology as an outpatient. Despite outpatient analgesia, he continued to experience pain and returned to the ED, where repeat ultrasonography demonstrated bilateral torsion with hypoperfusion. Discussion Although testicular torsion is uncommon, the clinician must recognize torsion; if left untreated, torsion leads to infertility. Previous publications suggest that ultrasonographic findings of bilateral testicular torsion should be attributed to “technical failure” rather than a plausible diagnosis. However, this case demonstrates the importance of maintaining a high index of suspicion, especially with an atypical age range and pathological presentation, particularly among men during their reproductive years.

The effectiveness of a theology-focused marriage preparation program was tested for a group of Catholic couples (N=200). Each couple had been married for less than five years and participated in the same program. The program covered a variety of topics from communication enhancement to a Catholic theology of marriage, including marriage as a vocation and natural family planning. The study assessed the retrospective perceptions of change for relational and spiritual behaviors and attitudes, in light of these theological and relationship teachings. Couples reported increases in positive thinking about the relationship, deeper understanding of marriage as a vocation, and improved communication. However, the program produced less change in Mass attendance, and NFP practice. Results were moderated by cohabitation history, support of mentor couples and length of marriage. Views of marriage in terms of vocation and increased knowledge of NFP were indirectly linked to higher relationship satisfaction via improved communication.

The Catholic Church promotes natural family planning (NFP) as a moral means to help couples postpone, prevent, or achieve pregnancy. Past research indicated that many Catholic couples chose artificial contraception rather than NFP, despite being introduced to NFP in marriage formation, which includes the classes that couples take prior to being married in the Catholic Church. Data are limited concerning why couples choose not to practice NFP or how NFP relates to couples’ relationship functioning and their dyadic spirituality. Drawing on data collected from two studies in separate dioceses (one urban and one rural), this article examined the usage rates of NFP, predictors of use, and the effects of NFP on relationship functioning and spiritual intimacy. Results indicated that older age and having cohabited prior to marriage predicted less likelihood of using NFP, while viewing marriage as sacred and shared Mass attendance indicated higher likelihood of NFP use. Furthermore, using NFP predicted higher spiritual intimacy for couples as well as higher relationship satisfaction. Couples’ increased exposure to NFP as a result of premarital education did not impact their decision to use NFP in marriage.