Urology

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Testicular exploration for torsion

Testicular exploration for torsion

Testicular torsion is a condition where the spermatic cord is twisted and interrupts the blood flow to testicles. Spermatic cord is a cord-like structure with bunch of blood vessels and other structures in the scrotum that leads to testicles. The condition is more common during infancy and boys going through puberty.

The exact cause of the condition is not known, but the condition may be developed because of inadequate connective tissue within the scrotum. The condition may also occur from injury to the scrotum or after strenuous exercise. An individual with testicular torsion may experience severe pain and sudden swelling in one testicle, nausea, vomiting, dizziness, or blood in the semen.

Testicular torsion is often diagnosed by physical examination where a person presents with painful scrotum and testes swollen on one side.  In addition urinalysis and blood tests may be ordered. Doppler ultrasound may be performed to evaluate the blood flow in the testis.

Testicular torsion can be treated by surgery and no other conservative treatments are available. In emergency room, narcotic analgesics such as morphine can be given to relieve pain. Surgery should be performed within 6 hours after symptoms begin, to save the testicles. Testicular torsion repair is surgery to untwist a spermatic cord. The surgery is performed under general anesthesia. An incision or a surgical cut is made in the scrotum to reach the twisted cord. The spermatic cord and the testicle are straightened. After successful straightening of the cord, testicle is attached to scrotum by sutures to avoid twisting in future. This procedure is called orchiopexy. The other testicle will be fixed in the same way because of the risk of torsion in future. If the condition is not treated immediately, the condition may worsen and necessitate the removal of testicle. Orchiectomy is a surgical procedure to remove one or both testicles.

Following the surgery, you may be advised to follow certain instructions for better results.

• Cold compresses to reduce pain and swelling
• Ensure rest for a week or longer
• Avoid strenuous exercises
• Wearing snug underwear to support the scrotum