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Q. Is orchiectomy necessary for testis torsion?

Answered by
Dr. Choudhary Devendra
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 01, 2017 and last reviewed on: Oct 09, 2018

Hi doctor,

I am in need of your help. I had torsion in the left testis; however, it cannot be treated within the time. Now, 12-15 days has already passed. The doctor has suggested for orchiectomy (removal of the left testis) and fixing of right testis. Is orchiectomy necessary? What are the other things I should consult? What are side effects? Is there any other alternative to this? If I did not get orchiectomy, will it cause any negative impact?

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#

Hi,

Welcome to icliniq.com.

  • The need of orchidectomy can be discussed, but the need of right side fixation that is, orchidopexy is compulsory to avoid mishap on the other side also.
  • One testis is enough for sexual characters and to bear a child.
  • In the same sitting, both testes can be evaluated. If the left testis with long duration torsion is still swollen or painful, then it would be prudent to remove that.
  • But, vital is the fixation of the opposite testis.
  • What is the Doppler study of scrotum saying at present?

Investigations to be done:

Doppler USG of scrotum.

Treatment plan:

Left orchiectomy with right orchidopexy.

Regarding follow up:

Revert with the details to a urologist online.---> https://www.icliniq.com/ask-a-doctor-online/urologist

Hi doctor,

I have attached the color Doppler report. According to it, no vascularity is found in the left testis. There is no pain. However, it is still a bit swollen. What are the side effects of orchiectomy? Will the scrotum shrink?

#

Hi,

Welcome back to icliniq.com.

  • From the reports (attachment removed to protect patient identity), the left testes will mostly land up in orchiectomy. If you do not get it removed, it is going to be self-necrosed, and after a year you will be left with only grain sized testis on the left.
  • Now on removing left testes left hemiscrotum is going to be empty.
  • I have observed that 80% female sexual partners fail to appreciate this loss of one testis and even if they notice they do not attach so much importance to it as single testis is enough to keep you manly and help you to make your wife bear children.
  • Just avoid sports with the risk of injury to your left over testis.
  • The other option is to put testicular prosthesis of the same size as opposite one. But, it cannot match the natural feel as it becomes noticeable on palpation.

For further information consult a urologist online --> https://www.icliniq.com/ask-a-doctor-online/urologist


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