Reduction of torsion of testis, surgical, with or without fixation of contralateral testis
CPT4 code
Name of the Procedure:
Reduction of torsion of testis, surgical (also known as orchiopexy or testicular detorsion).
Summary
A surgical procedure to untwist and secure a twisted testicle, restoring blood flow. The unaffected testicle may also be fixed to prevent future torsion.
Purpose
To address testicular torsion, a condition where the spermatic cord twists and cuts off blood supply to the testicle, potentially causing permanent damage or loss of the testicle if not promptly treated. The goal is to save the testicle and prevent recurrence.
Indications
- Sudden, severe testicular pain and swelling.
- Nausea or vomiting associated with testicular pain.
- Physical examination or imaging confirms torsion.
Preparation
- Fasting for at least 6-8 hours prior to surgery.
- Adjustment or discontinuation of certain medications as directed by the doctor.
- Preoperative blood tests or imaging studies (e.g., ultrasound) to confirm diagnosis.
Procedure Description
- The patient is given general anesthesia to ensure comfort and unconsciousness during the surgery.
- A small incision is made in the scrotum.
- The surgeon carefully untwists the spermatic cord to restore blood flow to the testicle.
- The testicle is then secured (fixed) to the inside of the scrotum to prevent future torsion.
- The contralateral (opposite) testicle may also be fixed as a preventive measure.
- The incision is closed with sutures.
Duration
The procedure typically takes about 45 minutes to 1 hour.
Setting
Performed in a hospital operating room or a specialized surgical center.
Personnel
- Surgeon (urologist or pediatric surgeon)
- Anesthesiologist
- Operating room nurses and surgical technicians
Risks and Complications
- Infection
- Bleeding
- Reaction to anesthesia
- Injury to the testicle or surrounding structures
- In rare cases, loss of the testicle if blood flow cannot be restored in time
Benefits
- Relief of pain and swelling
- Preservation of the testicle and its function
- Prevention of future torsion
Recovery
- Monitoring in a recovery room immediately post-surgery.
- Instructions on scrotal support, pain management, and activity restrictions.
- Avoiding strenuous activities and heavy lifting for several weeks.
- Follow-up appointments for wound check and to ensure proper healing.
Alternatives
- Manual detorsion (attempted reduction without surgery), which is often unsuccessful or temporary.
- Immediate surgical intervention remains the most effective and definitive treatment.
Patient Experience
Patients will be under general anesthesia and will not feel anything during the procedure. Post-procedure, there may be pain and swelling, manageable with prescribed pain relief. Discomfort should gradually decrease in a few days to weeks with proper care and following post-operative instructions.