Media Release
Dubai, Dec 9: A seven year old boy was brought to the emergency department with history of accidental fall on a sharp hook on the pram while playing with his brother.
After initial resuscitation, a detailed examination revealed a complete loss of half of the scrotum and avulsion of the testes with the testes hanging loosely outside.
Dr Thirumurthy Satishkumar
As it was an open wound with significant scrotal loss,immediate reconstructive surgery was required for the following reasons:
1.Avoidance of infection.
2.Maintaining the viability of the testes.
Scrotal reconstruction and testicular repositioning in complete loss of scrotum is a challenging operation because the scrotum has inherent properties to keep the testes at a lower temperature than the normal body temperature(this is required for adequate sperm production) and to achieve this with a reconstructed scrotum is the challenge which lies in this procedure. the other problem is that the testes can undergo twisting after being put in its neo scrotum. This is another problem that needs to be looked into.
This patient was taken up for emergency exploration and reconstruction of the scrotum. The surgery was done by Dr Thirumurthy Satishkumar.
A technique called the crural advancement flap with cremasteric interposition was used to reconstruct the scrotum.
After reconstruction of the scrotum, an operative procedure was done to fix the testes to prevent its possible future twisting in the neo scrotum.
A Doppler evaluation (an ultrasound like test) was done to ensure that the blood supply to the testes was preserved and adequate.
The patient was put on antibiotic cover and was discharged from the hospital after two days.
Periodic review of the patient was done and on the seventh post operative day, testicular and neo scrotal sensations and cremasteric reflex assessments were done(these are done to assess the success of the neo scrotum). All the tests were positive indicating that the neo scrotum was fully functional signaling the success of the surgery.