Recurrent Testicular Torsion After Prior Surgical Fixation: A Two-Case Series and Technical Insight into Orchidopexy Failure.

Background

Testicular torsion is a urological emergency that requires prompt diagnosis and surgical intervention to preserve testicular viability. Bilateral orchidopexy is widely regarded as the definitive treatment for the prevention of recurrence. Cases: We report two rare cases of recurrent testicular torsion despite prior surgical fixation. Both patients had previously undergone orchidopexy and presented with acute scrotal pain. Surgical exploration confirmed torsion in both cases, despite macroscopically intact fixation sutures. Intraoperative findings suggested that recurrence resulted from insufficient restriction of mobility rather than suture failure. Revision orchidopexy with modified multi-point fixation was performed, resulting in successful detorsion and the preservation of testicular perfusion.

Results

These cases highlight that orchidopexy does not universally prevent recurrent torsion and emphasize the critical importance of surgical technique, including suture placement, orientation, and number of fixation points. Increased awareness of potential re-torsion is essential, even in previously pexied patients. Improved standardization of fixation techniques may help reduce the risk of recurrence.