Emergency Scrotal Exploration + Detorsion + Bilateral Orchidopexy
Emergency Surgery to Save the Twisted Testis and Prevent Recurrence
What is Emergency Scrotal Exploration + Detorsion + Bilateral Orchidopexy?
Emergency Scrotal Exploration is the only definitive treatment for testicular torsion — a urological emergency where the spermatic cord twists cutting off blood supply to the testis. Through a scrotal incision, the testis is untwisted (detorsed) and its viability assessed. If viable, bilateral orchidopexy (fixation of both testes to the scrotal wall with non-absorbable sutures) is performed to prevent recurrence on either side. Time is critical — over 95% salvage rate if operated within 6 hours, dropping to less than 10% after 24 hours.
All patients with suspected testicular torsion presenting with acute scrotal pain — this is a surgical emergency requiring immediate intervention without delay for imaging. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.
How the Procedure Works
Immediate Scrotal Incision
Immediate scrotal incision under general anaesthesia — no delay for investigations.
Torsion Identification
Spermatic cord examined; direction of torsion identified; testis untwisted (detorsed).
Viability Assessment
Testis wrapped in warm saline-soaked gauze; viability assessed over 5–10 minutes.
Orchidopexy
If viable: orchidopexy of both testes performed with 3 non-absorbable sutures each to prevent future torsion.
Wound Closure
Wound closed; contralateral orchidopexy prevents future torsion on the other side.
Outcomes
Who Needs This Treatment?
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Emergency intervention is the only way to save the torted testis.
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Over 95% testicular salvage rate when operated within 6 hours of onset.
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Bilateral orchidopexy performed simultaneously preventing contralateral torsion.
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Avoids the need for orchidectomy and testicular prosthesis insertion.
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Short scrotal incision with rapid recovery — most patients discharged the same day.
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Definitive treatment for anatomical bell-clapper deformity predisposing to torsion.
"Testicular torsion is the one urological emergency that truly cannot wait. Every minute counts — we operate immediately on clinical suspicion alone; imaging has no role when a testis is at risk."
— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon
Common Questions
Frequently Asked Questions
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