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Fixation of a single testis: always, sometimes or never
S F Mishriki1, D C Winkle, J D Frank
1Department of Paediatric Surgery, Royal Hospital for Sick Children, Bristol.
British Journal of Urology
|March 1, 1992
Summary
Fixing a single undescended testis is not standard practice among British surgeons, despite cases of subsequent torsion. This study highlights the need for routine testicular fixation to prevent the loss of solitary testes.
Area of Science:
- Pediatric Surgery
- Urology
- Reproductive Medicine
Background:
- Orchiectomy for intravaginal testicular torsion typically involves fixing the contralateral testis.
- A practice exists to fix a single undescended testis to mitigate torsion risk.
Purpose of the Study:
- To determine the current practice regarding the fixation of a single undescended testis among British surgeons.
- To assess the prevalence of contralateral testicular fixation in cases of solitary testes.
Main Methods:
- A questionnaire was distributed to 67 consultant pediatric surgeons and urologists in Great Britain.
- The questionnaire aimed to ascertain their practices concerning the fixation of a single testis.
- Responses from 66 surgeons were analyzed.
Main Results:
- Only 11% of surgeons always fix a single testis; 42% sometimes do, and 47% never do.
- Six cases of torsion in a second unfixed testis were reported after the loss of the first for non-intravaginal torsion reasons.
- Causes included neonatal supravaginal torsion, undescended testis torsion, and testicular atrophy post-herniotomy.
Conclusions:
- The devastating loss of solitary testes due to torsion underscores the importance of testicular fixation.
- Contralateral testicular fixation after orchiectomy, regardless of the reason, is deemed mandatory.
- Current surgical practices vary, indicating a need for standardized management of solitary testes.