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A 21-year-old male asked:

What is atraumatic scrotal pouch orchiopexy in the management of testicular torsion? is it better than permanent insoluble sutures

3 doctor answers3 doctors weighed in
Dr. Gregory Lewis
Urology 44 years experience
In theory, Yes: Goals of testis torsion surgery: undo torsion in timely fashion to preserve testicular function and fixate both testicles so that torsion will not recur. Traditionally, fixation done by placing 2-3 sutures thru testicle and adjacent inner scrotal wall. Some feel these fixation sutures may cause some damage. Unknown. Placing testicle in 'dartos' pouch avoids need for placing sutures. Better?
Dr. George Klauber
Specializes in Pediatric Urology
Agree with Dr. Lewis regarding fixation with 3 sutures. Scrotal pouch without testicular fixation is NOT standard of care and tesis would still be at risk for torsion until it became adherent to the scrotal pouch.
Apr 21, 2014
Dr. George Klauber
Specializes in Pediatric Urology
Not standard care: Accepted standard of care for testicular torsion is a simple scrotal incision, entering each hemi-scrotal compartment sequentially, starting with the tossed testicle ; pexing (attaching) each testicle to inner scrotal wall with permanent insoluble sutures. Pouch orchidopexies are 4 small undescended testes ; not for fully developed tossed testes.
Dr. James Lin
A Verified Doctoranswered
A US doctor answeredLearn more
Unnecessary...: To fix testis in subdartos pouch is selectively applied to managing undescended testis. And it's unnecessary for twisted testis but just suturing and fixing it with 2-3 non-absorbable stitches to dependent corresponding spots of dartos muscles.

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Last updated Jun 11, 2019

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