Retractile Testis

Fixation of a retractile testis

Q 1. What does the procedure involve?

A. Division of the muscles in the groin causing retraction and fixation of the testicle in the scrotum.

Q 2. What are the alternatives to this procedure?

A. Observation, manual manipulation.

Q 3. What should I expect before the procedure?

A. If you are taking blood thinning medication on a regular basis, you must discuss this with your urologist because these drugs can cause increased bleeding after surgery. There may be a balance of risk where stopping them will reduce the chances of bleeding but this can result in increased clotting, which may also carry a risk to your health. This will, therefore, need careful discussion with regard to risks and benefits.

Aspirin does not usually need to be stopped but will be the decision of your surgeon.

You will usually be admitted on the same day as your surgery, or a day before. You will normally undergo pre assessment on the day of your clinic. After admission, you will be seen by members of the medical team which may include the consultant, junior urology doctors and nurse.

You will be asked not to eat or drink for six hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy.

Please be sure to inform your urologist in advance of your surgery if you have any of the following:

  • Co-morbidities like Diabetes, Hypertension, Coronary artery disease or, stroke, epilepsy
  •  Any transmissible disease like HIV/AIDS, Hepatitis B or C etc
  • Presence of implants, pacemakers, graft etc
  • You are taking prescription drugs like-
    • Blood thinners/ anti-platelets i.e. Warfarin, ecosprin, clopidogrel etc
    •  Anti-epileptics like phenytoin, valproate etc

Q 4. What happens during the procedure?

A. Either a full general anaesthetic (where you will be asleep throughout the procedure) or a spinal anaesthetic (where you are awake but unable to feel anything from the waist down) will be used. All methods minimise pain; your anaesthetist will explain the pros and cons of each type of anaesthetic to you.

A small incision is made in the groin to free the muscle retracting the testis so that it can be brought down into the scrotum. A second incision is then made in the scrotum to receive the testis where it is anchored to prevent twisting and further retraction.

Q 5. What happens immediately after the procedure?

A. You may experience discomfort for a few days after the procedure but painkillers will be given to you to take home. Absorbable stitches are normally used which do not require removal.

The average hospital stay is 24 to 36 hours.

Q 6. What are the side effects/complications?

A. Most procedures have a potential for side effects. You should be reassured that, although all these complications are well recognised, the majority of patients do not suffer any problems after a urological procedure.

Common (greater than one in 10)

  • Swelling of the scrotum lasting several days
  • Seepage of yellowish fluid from the wound several days after surgery

Occasional (between one in 10 and one in 50)

  • Infection of the testis or the incision requiring further treatment
  • The testis may remain slightly high in the scrotum

Rare (less than one in 50)

  • Bleeding requiring further treatment
  • The testis may shrink (atrophy) due to poor blood supply after the operation

Q 7. What should I expect when I get home?

A. When you leave hospital, you will be given a discharge summary of your admission. This holds important information about your inpatient stay and your operation.

For most patients, recovery will be rapid although the groin may be painful for several days. For children, two weeks off sport at school is sensible and vigorous exercise should be discouraged for the first two weeks.

In young adults, a period of 10 to 14 days off work is advisable.

Q 8. What else should I look out for?

A. If you develop a temperature, increased redness, throbbing or drainage at the site of the operation, please contact your urologist.

Q 9. Are there any other important points?

A. A follow up outpatient appointment will be scheduled in first week after discharge followed by an appointment at six to eight weeks after the operation to assess the cosmetic result.