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Will contralateral orchidopexy for testicular torsion affect fertility?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At January 1, 2020
Reviewed AtJuly 20, 2023

Patient's Query

Hello doctor,

I am a 19-year-old medical student. This year, I lost my right testis to testicular torsion, resulting from late diagnosis. As a precautionary measure, a contralateral orchidopexy was also done. This involving a part so intimately connected to me shattered me a lot and I am recovering slowly from that mental trauma. Besides, the fear of a retorsion in the left one and its subsequent loss keeps lingering. I am also concerned about orchidectomy's impacts on my fertility and hormonal levels. Can you please allay my fears? Also, my surgeon's report says, "The left scrotum was exposed, left testis exposed, very mild hydrocele, eversion of sac done using 4.0 monofilament suture, left lateral wall of testis fixed with 4.0 monofilament suture at two points, skin closed". Is this fine? Why was the sac everted? And what about the hydrocele? I have heard the 4.0 monofilament used was absorbable. If so, then how can those two sutures on the left testis prevent it from further torsion? Will there be some tissue formation eventually that will hold the testis in place? Or is it because by then the testis will get naturally attached to gubernaculum? As I presume the sutures were made into tunica albuginea. However, I read somewhere that this might have impact on sperm production. Is it true? Lastly, can I by any means, ascertain whether my left buddy is fine at home? By physical examination? Does the presence cremasteric reflex always rule out a possibility of necrosed testis?

Hello,

Welcome to icliniq.com.

First of all, relax and do not worry at all. We had done orchidectomy due to torsion in many patients. They are absolutely fine and doing well physically as well as mentally. Having one testis remaining is perfectly fine. You will have no problem regarding sperm production or testosterone levels. Your left testis can produce enough sperms for fertilization (only one sperm is required for fertilization). The surgeon has done a perfectly good job in the right testis. Eversion of the sac was done for hydrocele so that in future you do not develop hydrocele. Also, fixation with 4.0 monocryl is perfect. It just requires fixation at two points so that is cannot twist in the future. If suture are absorbable also no problem as it will cause fibrosis at the suture site so your testis remains fixed in the correct position.

So do not worry, everything is fine.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Khant Shahil Ramesh Bhai
Dr. Khant Shahil Ramesh Bhai

Urology

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