How is the procedure performed?

You will be admitted to the hospital and taken to the theatre. The procedure is done under general anaesthesia. The anaesthetist will keep you asleep and help with pain management. A small cut is made in the scrotum to get to the twisted cord. The testicle will be turned in the opposite direction until the spermatic cord is untangled. The surgeon will then apply a suture on the side of the testicle and fix it to the scrotal sidewall. This will prevent the testicular torsion to happen again. The other testicle will also be attached to the scrotal wall to prevent any future problems.

Testicular torsion is an emergency. In most cases, surgery is needed right away to relieve the pain and also prevent loss of the testicle. Best results are normally when the surgery is done within 4 hours of the onset of the symptoms. Sometimes, if the torsion is present for longer than 12 hours, the testicle will have lost its function permanently and will be removed surgically in theatre.

Diagram

What are the risks of the surgery?

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

What happens before the procedure?

Because this is an emergency procedure, it will be done as soon as possible and very little time will be wasted on doing medical tests beforehand. You may have an imaging test like an ultrasound that can check for blood flow in the testicle. Most of the time you will be given pain medication and book for theatre as soon as possible.

What happens after the procedure?

After the surgery, you will be given pain medication, an ice pack to relieve the pain and swelling and put on bed rest. Do not put the ice pack directly on your skin, wrap it in a towel or a cloth and apply it for periods of 10 minutes at a time on the surgical site. You will be required to rest at home for several days. You may wear a scrotal support for a couple of days after the surgery.

Avoid any strenuous activity for the first 2 weeks. After that, you can start slowly start doing your normal activities. Avoid contact sports for at least 4 weeks. You may resume sexual activity after about 4 to 6 weeks.

What can I expect afterwards?

If the surgery is done in time you should have a complete recovery. When it is done within the first 12 hours after symptoms start, the testicle can be saved most of the time. If the testicular torsion has been present for a period of longer than 12 hours and your testicle is removed, the other testicle will be fixed. The remaining alpha testers should provide enough hormones for normal mail growth, sex life and fertility.

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