PMID: 11906424Mar 22, 2002Paper

Recurrent torsion after previous testicular fixation

ANZ Journal of Surgery
Henry SellsGeoffrey D Burfield


Occasionally patients present with acute testicular pain having undergone a previous testicular fixation for torsion. The aim of this article is to review the literature and determine whether recurrent torsion of the testis is possible and whether the technique used at initial fixation is relevant. A literature search was performed using MEDLINE, Pre-MEDLINE, EMBASE and CIANHL databases using the terms 'spermatic cord torsion' and 'testicular torsion' in combination with 'treatment failure', 're-operation' or 'recurrence'. Twenty cases of recurrent testicular torsion after fixation are described. Fifteen of the 17 that specified the type of suture used at initial fixation had used absorbable suture. Animal models suggest that to produce dense adhesions at testicular fixation, the tunica vaginalis must be everted behind the testis with or without fixation, before the testis is returned to the scrotum. Without this eversion, the adhesions around the testis are fine and only located at the site of fixation suture. The use of non-absorbable suture led to abscess formation in 30% of testes in animal models. The higher incidence of recurrent torsion after fixation using absorbable rather than non-absorbable sutures in the literature ...Continue Reading


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