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Testicular torsion repair

Testicular torsion repair is surgery to untangle or untwist a spermatic cord. The spermatic cord is the collection of blood vessels in the scrotum that lead to the testicles. Testicular torsion develops when the cord twists. This pulling and twisting blocks blood flow to the testicle.

Testicular torsion

Testicular torsion is the twisting of the spermatic cord, which supports the testes in the scrotum. When this occurs, blood supply is cut off to the...

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Description

Most people will get general anesthesia for testicular torsion repair surgery. This will make you asleep and pain-free.

General anesthesia

General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel pain during surgery. After you receive the...

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To perform the procedure:

The surgeon will make a cut in your scrotum to get to the twisted cord.

Scrotum

The scrotum is a part of a male's body that is located behind the penis. The scrotum is the sac (pouch) that contains the testes, epididymis, and th...

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The cord will be untangled from the testicle. The surgeon will then attach the testicle to the inside of your scrotum using stitches.
The other testicle will be attached in the same way to prevent future problems.

Why the Procedure Is Performed

Testicular torsion is an emergency. In most cases, surgery is needed right away to relieve pain and swelling and to prevent the loss of the testicle. For the best results, surgery should be done within 4 hours after symptoms begin. By 12 hours, a testicle may become damaged so badly that it has to be removed.

Risks

Risks of this surgery are:

Bleeding

Bleeding

Bleeding is the loss of blood. Bleeding may be:Inside the body (internally) Outside the body (externally)Bleeding may occur:Inside the body when blo...

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Infection
Pain
Wasting away of the testicle despite the return of blood flow

Before the Procedure

Most of the time, this surgery is done as an emergency, so there is often too little time to have medical tests beforehand. You may have an imaging test (most often ultrasound) to check for blood flow and tissue death.

Most of the time, you will be given pain medicine and sent to a urologist for surgery as soon as possible.

After the Procedure

Following your surgery:

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. Slowly start doing your normal activities.
You may resume sexual activity after about 4 to 6 weeks.

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 most of the time.

If 1 testicle has to be removed, the remaining healthy testicle should provide enough hormones for normal male growth, sex life, and fertility.

Open References

References

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 . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 99.

Barthold JS. Abnormalities of the testes and scrotum and their surgical management. In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 132.

Elder JS. Disorders and anomalies of the scrotal contents. In: Kliegman RM, Stanton BF, St Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 545.

Wampler SM, Llanes M. Common scrotal and testicular problems. Prim Care . 2010;37:613-626. PMID: 20705202 www.ncbi.nlm.nih.gov/pubmed/20705202 .

Male reproductive anatomy - illustration

The male reproductive structures include the penis, the scrotum, the seminal vesicles and the prostate.

Male reproductive anatomy

illustration
Testicular torsion repair - series

Presentation

<strong>Normal anatomy</strong><p>The testicles are suspended in the scrotal sac. </p>

<strong>Indications</strong><p>Testicular torsion occurs when the testicle, normally attached to the scrotum by a small ligament at its base, becomes loose. The testicle can then twist on itself, cutting off its flow of blood. Testicular torsion is considered an emergency. Surgery is usually required, and it should be performed within about 5 hours from the onset of symptoms to save the testicle. </p>

<strong>Procedure</strong><p>General anesthesia is used and the patient is deep asleep and pain-free. An incision is made in the scrotum, the testicle is uncoiled, and an absorbable suture is placed to secure the testis from rotating again. The unaffected testicle is also secured by suture because the problem tends to occur on both sides and the unaffected side is at increased risk for torsion at a later date. </p>

<strong>Results</strong><p>After surgery, ice packs are applied to relieve pain and swelling. A scrotal support may have to be worn for a week after surgery. Normal activity may be resumed gradually. </p>

Male reproductive anatomy - illustration

The male reproductive structures include the penis, the scrotum, the seminal vesicles and the prostate.

Male reproductive anatomy

illustration
Testicular torsion repair - series

Presentation

A Closer Look

Self Care

Tests for Testicular torsion repair

Review Date: 8/31/2015

Reviewed By: Jennifer Sobol, DO, urologist at the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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