A Scrotal Fixation of Testes (or Scrotal Orchidopexy) is the name of the operation used to treat Bell Clapper Testes.
Bell Clapper Testes are an abnormality of the testicles that makes it more likely for a boy to develop a Testicular Torsion. A testicular torsion is a condition where the testicle twists on its own blood supply. If it is not untwisted quickly enough the testicle can die. More information on Bell Clapper Testes can be found here.
How is the operation done?
The surgery is performed as a Day Case Procedure. This means that your son will normally be discharged home on the same day.
Occasionally there may be a reason that it may not be possible to discharge you on the same day. The reason for this will be discussed with you at the time of the operation.
Your son will receive a Full General Anaesthetic for this operation. This means that they will need to fast before the surgery. Full details on fasting will be given to you before admission.
As well as the General Anaesthetic your son will have local anaesthetic injected into the scrotum during the operation. This means that when they wake up from surgery they will not feel any pain.
A cut is made on each side of the scrotum. (There will be a cut on each side of the scrotum.)
The testicle is delivered and the tunica (tissue that surround the testicle) is opened. The testicle is examined to make sure there are no other problems with it.
It is then placed back into a pouch within the scrotum. The cut in the scrotum is closed with dissolving stitches. You will be able to see these stitches. They will fall out after about 10 days.
How long will the surgery take?
Performing Scrotal Fixation of Testes on each side normally takes about 30 minutes to do if it is uncomplicated (about 15 minutes for each side).
This time does not include the time for the anaesthetic or the recovery of your son from the anaesthetic after the surgery is over.
Are there any risks to the surgery?
There are risks with all operations. The potential risks of this Scrotal Fixation of Testes include:
Bleeding - There is a small risk of blueing after this surgery. If bleeding does happen it normally settles by itself, or with some pressure over the wound. In rare cases more severe bleeding can occur, which can cause a collection of blood to collect within the scrotum. This is called a Haematoma. If a Haematoma does occur then it may need another operation to ‘evacuate’ it from the scrotum.
Infection - If this occurs it may need antibiotics to treat it. If a Haematoma has developed and this becomes infected, it may need an operation to clear the infected Haematoma from the scrotum.
Orchalgia - This is the medical name for pain in the testicle. There is a small risk of developing chronic pain in the the testicle after any surgery that exposes the testicle to the air. This pain may last for weeks or months. It can be very difficult to treat.
Failure - The aim of this surgery is to fix the testicle so that it will not tort. There are a number of case reports in the literature reporting torsion in patients who have had their testicles fixed. If your son complains of new pain in their testicle it is important that he is seen by a doctor as soon as possible to rule out a torsion.
What Happens after the operation?
After the operation finishes your son will be woken up from the General Anaesthetic and taken to Recovery. Once he is awake you will taken to Recovery to be with him. You will all then come back to the ward. Your son will then be able to have something to eat and drink straight away. The vast majority of boys who have this surgery will be discharged home same day.
It is not uncommon for children to feel a bit sick for the first 24 hours after an anaesthetic. You should encourage your son to drink lots of fluid. As long as he is drinking it does not matter if he is off his food for a day or two.
You should keep the wounds on your son’s scrotum dry for 5 days. Do not allow your son to have a bath for 5 days, but use wet wipes to keep the area clean. You should get your GP to check the wounds after a week.
You should give your son regular pain relief for the first few days after the operation. Giving pain killers regularly is much more effective that waiting for someone to complain of pain before giving them something.
Your son should not ride a bicycle or any ride on toys for 2 weeks following the Scrotal Fixation of Testes.
You should call the ward or your family doctor (GP) if:
- your child is in a lot of pain and pain relief does not seem to help
- your child has a high temperature and paracetamol does not bring it down
- the wound site looks red, inflamed and feels hotter than the surrounding skin
- there is increasing swelling of the scrotum after the surgery
- there is any oozing from the wound