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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 unconscious and unable to feel pain.

After you receive anesthesia, the surgeon will make an incision (cut) in your scrotum to get to the twisted cord. The surgeon then will 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 for any anesthesia are:

• Breathing problems
• Allergic reactions to medicines

Risks for any surgery are:

• Bleeding
• Infection

Before the Procedure

Since this surgery is most often done as an emergency, there is usually not enough time to have medical tests beforehand. Sometimes a surgeon has the patient undergo 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 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 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

Ringdahl E, Teague L. Testicular torsion. Am Fam Physician. 2006;74:1739-1743.

Schneck FX, Bellinger MF. Abnormalities of the testes and scrotum and their surgical management. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 127.