Does the opposite side of testicular torsion need to be fixed?

After testicular torsion is diagnosed, the contralateral testis usually needs to be immobilized. Testicular torsion is a urological emergency. When the patient develops the disease, the blood supply to the affected testicle is interrupted due to torsion of the spermatic cord. At the same time, anatomic abnormalities of the contralateral testicle increase the risk of recurrence. Surgical fixation can reduce the probability of recurrence and the risk of contralateral disease.

The pathogenesis of testicular torsion is related to abnormal attachment of the testicular tunica vaginalis, which may be a bilateral anatomic defect. During simultaneous intraoperative exploration of the contralateral side, the same abnormality was found in approximately half of the patients. Contralateral fixation uses tunica albuginea suture to fix the testis and scrotal wall. The operation is less invasive and can effectively prevent recurrence of torsion. Because children and adolescent patients are still in the growth and development stage, preventive immobilization is recommended even if the contralateral side does not twist.

Some medical institutions may only treat the affected side during emergency surgery, but follow-up data show that patients with the unfixed contralateral side have a probability of secondary torsion. For those who have a history of intermittent pain or whose testicles are found to be straddling during physical examination, the probability of re-operative intervention will increase significantly. Delayed fixation may lead to irreversible damage to testicular function and long-term effects on fertility.

After diagnosis of testicular torsion, surgical reduction must be completed within 6 hours. Completing contralateral fixation within the golden treatment time can protect fertility function to the greatest extent. After surgery, regular ultrasound examinations are required to evaluate testicular blood flow, and strenuous exercise is avoided for 2-3 months. Pay attention to scrotal symmetry and pain symptoms in daily life. Young patients are advised to wear loose underwear to reduce local compression. People with high-risk factors such as cryptorchidism should seek medical attention as early as possible to evaluate the need for preventive fixation.