Emerging treatments
Intraoperative indocyanine green fluorescence imaging
During testicular exploration, the viability of the testis can sometimes be difficult to determine and the surgeon is faced with a decision on whether to perform an orchidopexy or orchidectomy. Reports in the literature from 2022 to 2023 have discussed utilising intraoperative indocyanine green fluorescence imaging to assess testicular viability.[50][51][52] Further large scale studies are needed to assess their utility in assisting intraoperative decision-making and to better understand their correlation with patients outcomes.
Testicular fasciotomy
A study has suggested that conceptualising testicular torsion as a compartment syndrome, and treating torsion with testicular fasciotomy along with a tunica vaginalis patch, relieves testicular compartment pressures and theoretically may lead to increased testicular tissue viability.[53] It has been shown that the degree of intra-testicular pressure after operative de-torsion can predict subsequent spermatogenesis and therefore may be an acceptable measure to predict the need for orchiectomy.[54]
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