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Testicular torsion repair
Definition
Testicular torsion repair is surgery to untangle a spermatic cord. The spermatic cord is the collection of blood vessels in the scrotum leading to the testicles. If it twists or turns, testicular torsion develops. This torsion (pulling and twisting) blocks blood flow to the testicle.
Description
Most patients receive general anesthesia for testicular torsion repair surgery. This will make you asleep and pain-free.
After you receive anesthesia, the surgeon will make a surgical cut in your scrotum to get to the twisted cord. The surgeon will then untangle the spermatic cord and testicle. The surgeon will use stitches to attach this testicle to the inside of your scrotum. The other testicle will be attached in the same way so that it does not twist in the future.
Why the Procedure Is Performed
Testicular torsion is an emergency. Surgery is usually needed right away to relieve the sudden severe pain and swelling and to prevent the loss of the testicle. For the best results, it should be performed within 6 hours after symptoms begin. By 12 hours, a testicle may become damaged so badly that it has to be removed.
Risks
Risks of any anesthesia are:
- Breathing problems
- Allergic reactions to medicines
Risks of this surgery are:
- Bleeding
- Infection
- Pain
- Testicular atrophy
Before the Procedure
Because this surgery is most often done as an emergency, there is usually not enough time to have medical tests beforehand. You may have an imaging test (usually ultrasound) to check for blood flow and tissue death.
You will probably be given pain medicine and be sent to a urologist for surgery as soon as possible. A urologist is a doctor who specializes in the surgery and treatment of genital and urinary problems and diseases.
After the Procedure
Pain medicine, rest, and ice packs will relieve pain and swelling after surgery. Do not put the ice directly on your skin. Wrap it in a towel or cloth. Rest at home for several days. You may wear a scrotal support for a week after surgery.
Avoid strenuous activity for 1 to 2 weeks, and sexual activity for about 4 to 6 weeks. Start doing your normal activities slowly.
Outlook (Prognosis)
If surgery is done in time, you should have a complete recovery. When it is done within 12 hours after symptoms begin, the testicle can be saved about 70% of the time.
If one testicle has to be removed, the remaining healthy testicle should provide enough hormones for normal male growth, sex life, and fertility.
References
Elder JS. Disorders and anomalies of the scrotal contents. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 539.
Wampler SM, Llanes M. Common scrotal and testicular problems. Prim Care. 2010;37:613-626.
Ban KM, Easter JS. Selected urologic problems. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 97.
Ringdahl E, Teague L. Testicular torsion. Am Fam Physician. 2006;74:1739-1743.
Barthold JS. Abnormalities of the testes and scrotum and their surgical management.In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 132.
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
