Our Summary

A 16-year-old boy came to the emergency room with severe pain in his lower right abdomen and was throwing up. He said he didn’t have any issues with urination, diarrhea, or pain in his testicles. When doctors checked him, they found that his lower right abdomen was very tender and he didn’t have a right testicle. The left testicle was not painful. His vital signs were stable. Doctors thought he might have appendicitis and a twisted testicle, so they performed a surgery to check. During the surgery, they found that the boy’s right testicle was twisted and not healthy, and it was inside his abdomen. After talking with specialists, they decided to remove the twisted testicle because it was shrunk and could turn into cancer. The appendix was normal. The boy recovered without any issues and was able to leave the hospital.

FAQs

  1. What is the procedure for diagnosing possible testicular torsion and acute appendicitis in a patient?
  2. What are the possible risks and complications associated with undescended testicle surgery?
  3. What is the typical recovery process after undescended testicle surgery?

Doctor’s Tip

A doctor might tell a patient undergoing undescended testicle surgery to follow post-operative care instructions carefully, including keeping the incision site clean and dry, avoiding strenuous activity or heavy lifting for a certain period of time, and taking prescribed pain medication as needed. It is also important for the patient to attend follow-up appointments to monitor healing and ensure proper recovery. Additionally, the doctor may advise the patient on potential long-term effects of the surgery, such as infertility or increased risk of testicular cancer, and discuss any necessary precautions or follow-up screenings.

Suitable For

Patients who are typically recommended undescended testicle surgery are those who have a condition known as cryptorchidism, where one or both testicles fail to descend into the scrotum. This condition is most commonly seen in male infants and young boys, but can also be present in older children and adults. Surgery is recommended in order to bring the testicle(s) down into the scrotum to prevent potential complications such as infertility, testicular cancer, and torsion (twisting of the testicle). In cases where the testicle is found to be atrophic or has significant malignant potential, as in the case described above, surgery may also be recommended to remove the affected testicle.

Timeline

Before undescended testicle surgery:

  • Patient may experience discomfort or pain in the abdomen or groin area
  • Patient may have a physical examination revealing an absent or undescended testicle
  • Patient may undergo imaging tests to confirm the diagnosis
  • Patient may be diagnosed with a torted or atrophic testicle with malignant potential
  • Patient may be scheduled for surgery to remove the affected testicle

After undescended testicle surgery:

  • Patient undergoes surgical excision of the torted or atrophic testicle
  • Patient may have a period of recovery in the hospital
  • Patient may be discharged once they have recovered adequately
  • Patient may have follow-up appointments with the urologist to monitor their recovery and overall health
  • Patient may experience improved symptoms and reduced risk of complications from the undescended testicle

What to Ask Your Doctor

  1. What are the potential risks and complications associated with undescended testicle surgery?
  2. How long will the recovery process take and what can I expect during the recovery period?
  3. Will there be any long-term effects or implications of having the surgery?
  4. What type of anesthesia will be used during the surgery and how will I be monitored?
  5. Will there be any restrictions or limitations on physical activity after the surgery?
  6. How will the surgery affect my fertility and hormone levels?
  7. Will I need follow-up appointments after the surgery and if so, how often?
  8. What are the alternative treatment options available for undescended testicles?
  9. How successful is undescended testicle surgery in terms of fixing the issue?
  10. Are there any specific steps I need to take before the surgery, such as fasting or stopping certain medications?

Reference

Authors: Malik MIK, Abbas J, Sabri S, Michael G, Ellenbogen S. Journal: BMJ Case Rep. 2020 Jan 29;13(1):e232179. doi: 10.1136/bcr-2019-232179. PMID: 32001538