Alternative Names scrotal orchidopexy, orchidopexy
Definition 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. If a twisted testicle is found when the scrotum is opened, the problem will be repaired and the testicle anchored.
How is the procedure performed? The surgery can be performed under general anaesthesia or regional anaesthesia. General anaesthesia means the person is put to sleep with medications. Regional anaesthesia 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 colour 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. The testis is then sutured to the scrotum to prevent a recurrent torsion. 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 orchidopexy. 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 will be taken to the surgery recovery room to be watched closely for a short time. Vital signs, blood pressure, pulse, and breathing will be checked frequently. A bulky bandage and a scrotal support may be applied. Some discomfort may be experienced. Analgesia is given to decrease the discomfort. This surgery may be done in a same day surgery setting, and the man is allowed to go home after recovering from anaesthesia. However, the patient usually remains in hospital overnight.
What happens later at home? At home, the person will 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 or scrotal support garment to reduce discomfort.
What are the potential complications after the procedure? There are complications with any surgery or anaesthesia. These include bleeding, infection, and reactions to the anaesthesia medications. Possible complications from this procedure include:
bleeding into the scrotum, known as a haematoma
re-twisting of the testicle. Rarely, the procedure to anchor the testicle is unsuccessful and it twists a second time.
Author: Stuart Wolf, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 12/06/2005 Contributors Potential conflict of interest information for reviewers available on request
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