Paediatric Surgery Trainee Research Network PSTRN;
British Urology Researchers Surgical Training BURST;
Boam, T;
Harwood, R;
Clement, KD;
Kasivisvanathan, V;
Light, A;
... Kulkarni, M; + view all
(2025)
A national survey of practice for the emergency fixation of testis.
The Annals of The Royal College of Surgeons of England
, 107
(1)
pp. 48-53.
10.1308/rcsann.2023.0101.
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Abstract
Introduction: Scrotal exploration for suspected testicular torsion is a common emergency procedure in the United Kingdom (UK). There is no universally agreed practice for how the testis should be fixed, or whether a nontorted testis should receive fixation. This survey aims to describe the methods used for emergency scrotal exploration and testicular fixation in the UK. // Methods: An online survey was distributed to urologists, general surgeons and specialist paediatric surgeons in approved NHS trusts, and via the email lists of collaborating organisations. The survey questioned surgeons on their operative management of a variety of common diagnoses encountered during scrotal exploration using multiple choice and free-text answers. // Results: A total of 340 responses were received from 83 institutions. Respondents included urologists (consultants, 33%; trainees, 24%), paediatric surgeons (consultants, 12%; trainees, 16%) and general surgeons. In cases of torsion, respondents predominantly perform sutured fixation (74%); however, sutureless dartos pouch fixation was used frequently (37%) by paediatric surgeons. The finding of ‘bell-clapper’ anatomy without torsion prompts 69% of respondents to undertake sutured fixation, but alternative nontorsion diagnoses frequently prompt use of sutureless methods (53–66%). // Conclusion: This study is the largest survey of methods for emergency scrotal exploration and describes current UK practice. The majority of surgeons prefer sutured fixation in cases of torsion and/or bell-clapper anomalies, and sutureless methods in the absence of it.
| Type: | Article |
|---|---|
| Title: | A national survey of practice for the emergency fixation of testis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1308/rcsann.2023.0101 |
| Publisher version: | https://doi.org/10.1308/rcsann.2023.0101 |
| Language: | English |
| Additional information: | Copyright © 2025, The Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License, https://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution, reproduction, and adaptation in any medium, provided the original work is properly attributed. |
| Keywords: | Testicular torsion; Orchidopexy; Genital diseases; Male; Testicular fixation; Scrotal exploration; Acute scrotum |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10204461 |
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