Recurrent torsion of the testis following previous surgical fixation

May, Roy E.; Thomas, W. E. G.

doi:10.1002/bjs.1800670218

Cited by 40 publications

(27 citation statements)

References 11 publications

(2 reference statements)

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“…Various methods of fixation are used by surgeons. There have been many reports of torsion occurring after previous testicular fixation (May and Thomas, 1980;Vorstman and Rothwell, 1982;Thurston and Whitaker, 1983). It has been suggested that the use of a non-absorbable rather than an absorbable suture will prevent this complication (Tawil and Gregory, 1984).…”

Section: Discussionmentioning

confidence: 99%

Fixation of a Single Testis: Always, Sometimes or Never

Mishriki

Winkle

Frank

1992

British Journal of Urology

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If it is necessary to perform an orchiectomy for an intravaginal testicular torsion it is the usual practice of surgeons to fix the contralateral testis. When faced with a child with only one testis for another reason it is our practice to fix this single testis to eliminate the small but disastrous risk of a torsion. We were interested to see whether this practice was usual and therefore sent out a questionnaire to the 67 consultant paediatric surgeons and urologists in Great Britain. Sixty-six surgeons replied. Seven surgeons (11%) always fix the single testis, 28 (42%) sometimes and 31 (47%) never fix a single testis. Five surgeons had looked after 6 patients who had a torsion of a second unfixed testis after losing the first for a reason other than intravaginal torsion. Four of these patients had initially had a neonatal supravaginal torsion, 1 had a torsion of an undescended testis and the sixth had severe testicular atrophy following an inguinal herniotomy. In our opinion the devastating loss of these solitary testes makes contralateral testicular fixation after an orchiectomy for whatever reason mandatory.

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Section: Discussionmentioning

confidence: 99%

Fixation of a Single Testis: Always, Sometimes or Never

Mishriki

Winkle

Frank

1992

British Journal of Urology

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“…In the lower part of the testis, the descend ing branch of the testicular artery is sometimes present [13,14], Injuries to these main blood vessels can be avoided by shallow suturing of the tunica albuginea. Suture was done with silk, because recurrence of torsion has been reported after fixation using catgut [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Orchiopexy for Intravaginal Testicular Torsion Ring-Shaped Fixation of the Lower Part of the Testis

Ishizuka¹,

Iwasaki²,

Sato³

et al. 1989

Eur Urol

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“…The findings at the secondary operation conclusively proved that these techniques were insufficient and thus unreliable: a) in 20 cases the testes were found to be lying freely in the vaginal cavity without any remnants of the previous fixation; (3,6,10,14,15,17,18,21,23,25,32,34,35); b) in 6 cases testes were equally free, with very scant signs of the previous operation (1,12,15,26,30,31); c) in one case the testis revolved around a previous suture (20); and d) in 9 cases testes were anchored by a stretched-out adhesion which, acting like an axis, had tended to favor torsion instead of preventing it (7,12,20,29,32).…”

Section: Findings At Reoperationsmentioning

confidence: 97%

“…The results after the secondary operation were: four orchiectomies (11, 30 ± 32); a ªgangrenousº (sic) testis, which was left in place because the controlateral organ had been removed at the primary operation (26); five confirmed atrophies (14,15,17,33); three foreseeable atrophies, according to the surgeons own assessment (29,34); and 12 ªnormalº testes. Within this so-called ªnormalº group, in a substantial number of cases the findings described at the secondary operation cast serious doubts as to the final destiny of the testes involved.…”

Section: Sequelae Of Failuresmentioning

confidence: 99%

Spermatic Cord Torsion After Testicular Fixation - A Different Surgical Approach and a Revision of Current Techniques -

Gesino

Santos²

2001

Eur J Pediatr Surg

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We present a technique for testicular fixation, based on the development of a new anatomical structure formed exclusively by the visceral and the parietal tunica vaginalis; our pre-clinical experience with this technique performed in guinea pigs and a clinical casuistic of 100 operations in 69 patients (age range: newborns to 25 years, mean 101.43 months) where the principal indications were unilateral torsion, testicular descent and contralateral fixation after orchiectomy. Postoperative follow-up ranged between 4 months and 204 months with a mean of 14.304 months. At their final follow-up, all patients presented normal testicular size, shape, consistency, sensitivity, mobility and intrascrotal position; no patient complained of symptoms related to the operation. The discussion also includes 48 cases of failed testicular fixation which were performed with sutures, vaginal adhesions or dartos-pouch techniques, as reported by 30 different authors. Ages of patients at the primary operation ranged from 3 years to 34 years (mean 14.381 years), at the secondary operation from 10 years to 40 years (mean 19.298 years) and the interval between them ranged from 5 days to 27 years (mean 53.773 months). The causes of the failures, which led us to consider them as unreliable, were absorption of cicatricial tissue, serosal regeneration and loosening of sutures. The sequelae included testicular atrophies, orchiectomies and severely damaged testicles.

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Recurrent torsion of the testis following previous surgical fixation

Abstract: Two cases of recurrent torsion of the testis following previous surgical fixation are described. The significance of this rare occurrence is discussed and it is recommended that total excision of the parietal tunica vaginalis is used for surgical fixation.

Cited by 40 publications

References 11 publications

Fixation of a Single Testis: Always, Sometimes or Never

Fixation of a Single Testis: Always, Sometimes or Never

Orchiopexy for Intravaginal Testicular Torsion Ring-Shaped Fixation of the Lower Part of the Testis

Spermatic Cord Torsion After Testicular Fixation - A Different Surgical Approach and a Revision of Current Techniques -

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