Testicular Torsion Repair

Alternate Names
scrotal orchiopexy
orchiopexy

Definition of Testicular Torsion Repair

The cord supplying blood to the testicle can become twisted in a condition known as testicular torsion. If this happens, blood flow can be cut off and the testicle can die. Testicular torsion repair is a surgical procedure in which the testicle is untwisted and anchored to the scrotum in the proper place.

Who is a candidate for the procedure?

Surgery is performed when a male has sudden pain in the scrotum and testicular torsion cannot be ruled out. The pain is very commonly associated with nausea, and the testicle may lie in the scrotum in a higher and horizontal position with or without swelling of the scrotum. If a twisted testicle is found when the scrotum is opened, the problem will be repaired and the testicle anchored or removed.

How is the procedure performed?

The surgery can be performed under general anesthesia or regional anesthesia. General anesthesia means the person is put to sleep with medications, feels no pain, and has no awareness of the procedure. Regional anesthesia means the person will be awake, but numb below the waist. A medication may be given to make the person drowsy.

To begin the operation, a cut is made in the scrotum and the testicle is brought out. The color of the testicle is observed and the cord is examined for signs of twisting. After the cord has been untwisted, it is wrapped in warm gauze that has been soaked in saline solution.

Next, the other testicle is secured to the scrotum with a few stitches. This is done because the anatomical defect that leads to a twisted testicle is frequently present on both sides. The anchoring procedure is known as orchiopexy.

The first testicle is then re-examined to see if it is recovering properly. If it appears that permanent tissue damage has taken place, the testicle is removed. If the testicle has recovered, it is secured with stitches to the scrotum. The incision is closed and a sterile dressing is applied.

What happens right after the procedure?

After the surgery, the person is taken to the surgery recovery room to be watched closely for a short time. Vital signs, blood pressure, pulse, and breathing are checked frequently. A bulky bandage and a scrotal support may be applied. Some discomfort may be experienced; it is usually reduced by pain medication. This surgery is usually done in a same day surgery setting, and the man is allowed to go home after recovering from anesthesia.

What happens later at home?

At home, the person must clean the wound and apply a new bandage as directed by the surgeon. The scrotum often swells significantly after surgery. The person should rest in bed as much as possible, and keep his scrotum elevated with a small pillow to reduce discomfort.

What are the potential complications after the procedure?

Surgery can be complicated by bleeding, infection, or reactions to the anesthesia. Possible complications specific to this procedure include:

• bleeding into the scrotum, known as a hematoma
• re-twisting of the testicle. Rarely, the procedure to anchor the testicle is unsuccessful and it twists a second time.