Testicular Fixation

Testicular fixation surgery is a brief and relatively simple operation, which is typically performed in two conditions: in case of testicular torsion (or if this is suspected) and in case of an undescended testicle. During the operation, the testicle is fixed to the scrotum, in order to prevent recurrence of the condition, and no less important, to allow its normal future development.

Most testicular fixation operations are performed at a very young age, at the age of around one year. That time it is very important to provide the testicle with optimal conditions for future development. Testicular torsion and undescended testicles could impair this process. It is therefore important to fix the testicle in the scrotum by the time the infant is two years old.

There are, of course, cases in which testicular fixation surgery is performed at a later age, even in adulthood (as testicular torsion can occur at any age). In all events, this operation is a very quick one, usually does not involve much pain and needs a relatively rapid recovery, depending, of course, on the complexity of the case.

It is important to note that there is a difference in approach between the two cases: In case of undescended testicle – a testicle that remained in the inguinal canal and has not descended down to the scrotum – the operation will not always be performed immediately, as the testicle usually “descends” with time to its natural place. On the other hand, in case of testicular torsion – when the testicle twists around itself – or when this is suspected, the operation will be performed immediately, as such a condition is liable to impair the development of the testicle and even cause necrosis of the testicle itself. Practically speaking, if the operation is performed 24 hours or more after the symptoms appear, the chance for saving the testicle is considered to be quite low.

General information about testicular fixation surgery

Testicular fixation surgery is performed under general anesthesia. In the case of testicular torsion, the treatment will be performed through a tiny incision in the scrotum itself, through which the testicle will be fixed in place. In the case of an undescended testicle, it is necessary to, first of all, bring it down from the inguinal canal to the scrotum, and only then is it positioned in the scrotum and fixed. Therefore, prior to fixation, the physician will make an incision in the lower abdomen, through which he will access the testicle in the inguinal canal, and bring it down to the scrotum. This operation can be performed by open access through a longitudinal incision, a few centimeters in length, in the lower abdomen; or by minimally invasive access, which requires only a few small incisions in the same region.

Preparing for the procedure

It is important to be healthy, with no fever, inflammation or the like when coming to have the operation performed. This is relevant mainly when the patient is an infant up to the age of two years, an age at which such phenomena are more frequent. The operation will be performed under general anesthesia, as mentioned above. A six-hour fast is therefore required beforehand.

The course of the procedure

As mentioned above, testicular fixation surgery is performed under general anesthesia, as part of the surgical procedure to return the testicle to its place – whether it be due to testicular torsion or due to undescended testicle. After the testicle is returned to its place (brought down from the inguinal canal to the scrotum, or rotated and returned to its natural position), fixation of the testicle in the scrotum will be performed.

Fixation is, in fact, a procedure in which a “pocket” is created in the scrotal tissue, the testicle is positioned in it and is sutured to the scrotum. This ensures that it will not be able to move from its place, enabling normal development. Prior to this procedure, the physician ensures that the testicle is completely free, in order to prevent a complication and other problems related to blood flow to and from the testicle.

In many instances of testicular torsion, the physician will decide to also fix the other testicle, in order to prevent in advance a similar manifestation occurring to it also.

Testicular fixation surgery usually takes approximately half an hour (except for complex cases necessitating treatment of additional problems in this region), and recovery is quite rapid. It will usually be possible to be released from the hospital on the same day or the next day.

If there is severe pain in the region of the operation, it is recommended not to wear excessively tightly fitting clothes. Additionally, it is recommended to drink plentiful amounts of water during the first few days after the operation. For one month after the operation, cycling should be avoided, and for at least the first two weeks, sexual activity should be avoided.

As mentioned above, in the case of infants, it is important for testicular fixation surgery to be performed as early as possible, because only in this way will the testicle be able to develop normally throughout the boy’s life. If the testicle is not fixed in time, the child could suffer in the future from fertility problems and even from various diseases connected to the testicles.

Side Effects after testicular fixation surgery

Because the operation is quite simple, there are also not many side effects. Nausea resulting from the general anesthesia is considered to be quite common in the 24 hours following the operation, and it passes by itself. Additional possible side effects are an infection at the site of the operation; swelling in the scrotum, in the region of the treated testicle; recurrence of the case and need to repeat the testicular fixation surgery. In general, these are very rare effects.