This article is for educational purposes only. It should not be used as a template for consenting patients. The person obtaining consent should have clear knowledge of the procedure and the potential risks and complications. Always refer to your local or national guidelines, and the applicable and appropriate law in your jurisdiction governing patient consent.
Overview of Procedure
Scrotal exploration is performed for cases of suspected testicular torsion, i.e. patients presenting with acute testicular pain.
The most common access is via a vertical midline scrotal incision to gain access to both hemiscrotum. The findings of the exploration often determine if subsequent fixation or orchidopexy will be performed.
It is imperative when consenting to ensure detailed informed consent is gained for the scrotal exploration +/- bilateral orchidopexy +/- suspected side orchidectomy.
Complications
Intraoperative
| Complication | Description of Complication | Potential Ways to Reduce Risk |
| Haemorrhage | Damage to the vessels of the spermatic cord | |
| Damage to surrounding structures | The vas deferens or associated neurovascular structures can be damaged; especially important to avoid if the testicle is viable | Careful dissection and identification of avascular plane, and ensure the identification of key structures throughout the procedure |
| Anaesthetic Risk | Includes damage to the teeth, throat and larynx, reaction to medications, nausea and vomiting, cardiovascular and respiratory complications | Forms a part of the anaesthetist assessment before the operation |
Early
| Complication | Description of Complication | Potential Ways to Reduce Risk |
| Pain | Pain from the incisions and internal handling of scrotal structures | Regular analgesia post-operatively and the use local anaesthesia at the incision site |
| Infection | Surgical site infections can develop at the incision site | Maintain an aseptic technique throughout the procedure |
| Haematoma formation | Accumulation of blood around the testes, however this will usually gradually resolve spontaneously | Adequate haemostasis intra-operatively |
Late
| Complication | Description of Complication | Potential Ways to Reduce Risk |
| Testicular atrophy | If the testis are damaged and non-viable, they will atrophy over time, reducing fertility | |
| Anti-sperm antibody production | Detorting an ischaemic testicle can lead to the production of anti-sperm antibodies in some cases | Tie off the testis proximally around cord if non-viable before performing orchidectomy |
| Chronic pain | Patients can develop chronic testicular pain due to fixation if an orchidopexy also performed |