Premise:
The sudden onset of severe testicular pain can be a sign of a testicular torsion. This pathology is due to a rotation of the testicle on its longitudinal axis with “choking” of arteries and veins and consequent suffering of the testicle. Other causes of intense pain in the testis may be acute orchiepididymitis (acute inflammation of testicle and epididymis).
Why the surgery:
If the testicle rotation will last for more than 6 hours after the pain onset, the testis undergoes irreversible damage (ischemic necrosis). Surgery should be performed urgently in order to clarify the diagnosis that can not be safely provided with instrumental examinations such as ultrasound.
Anesthesia:
Surgery is performed in general anesthesia.
Surgery info:
Surgery involves scrotum incision. If the testicle does not appear irreversibly damaged, it is only rotated back and secured. Otherwise it is necessary to remove it. In this case, if the patient agrees, a testicular prosthesis may be positioned for aesthetic purposes. If the testicle is removed, it is indicated to fix the remaining one to avoid a possible twist.
Complications:
They are infrequent and are essentially represented by pain, infections, scrotal hematoma, reduced testicular function. Under special conditions (patient with a single testicle), if the single testicle has intermediate vitality the likelihood of infection and testicular atrophy is high.
After the intervention:
The patient is generally discharged the day after surgery.
Suture stitches are absorbable and therefore do not need to be removed. Afterwards, absolute rest for 1 week and abstinence from heavy physical activity is recommended for 1 month. It is important to note that in the patient with both normal testicles, the removal of a testicle does not involve any hormonal, sexual and fertility consequences and does not alter his quality of life.