Suture Technique and Complications following Paediatric Testicular Fixation

Abstract

Aim: Following a case of stitch pain following testicular fixation after testicular salvage the authors sought to investigate whether fixation technique or suture type was associated with short and mid-term complications. Methods: All boys undergoing fixation of testes for emergency testicular torsion was identified over a 3-year period from prospectively maintained theatre registries. A retrospective case note review was undertaken with collection of surgical technique and the outcome of post-operative complications. Hospital board governance approval was awarded. Results: 40 boys had testicular torsion requiring unilateral or bilateral fixation as appropriate. Twenty-six children had 3-point fixation, 10 had single point fixation, 3 had 2-point fixation, and 1 operation note described a central box stitch. Thirty-five were fixed with Prolene, 3 with PDS and 2 with Vicryl. Ten children had post-op complications. Five had haematoma; 2 of which got infected. Two children had wound infection, but there was no wound dehiscence. Three children had excess acute post-operative pain. Three had persistent pain; with 1 child requiring removal of sutures which led to resolution of pain. There was no association of complications with technique or suture type. Discussion/Conclusion: Our data shows no superior technique in the fixation of testes following emergency detorsion. Though fixation is mandated by BAPU and ESPU references method of fixation remains surgeon preference. Following a case where severe stitch pain required a return to theatre and removal of suture material the authors were interested to see if fixation technique was associated with complications. The aim of this study is compare outcomes following testicular fixation by fixation technique.