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Consent: Scrotal Exploration +/- Orchidopexy +/- Orchidectomy

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Last updated: June 18, 2021
Revisions: 5

Last updated: June 18, 2021
Revisions: 5

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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
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