Bell Clapper Deformity

My husband is 35 and was recently diagonised with bell clapper deformity. We don't have any children but we plan to begin a family in a  year. He started having pain in the testicles a year or two ago and it would come and go. One night the pain had him rolled up in a ball crying. We went to the ER. However all test were negtive. Recently he had abdomen pain and our primary care physician sent him to a uriologist. He is going to perform a bilateral orchiopexy. How does this occur in adult men? He was potentail NBA material. He played college basketball and still plays organized basketball for men age 30 -40. Could he had been born with it? How do we know if it's heridity? If it is, how do you suggest we pose the question to a 75 year old uneducated man whom never visits the doctor but once every two years.Will we be able to have children? Could a car accident agrravated it to this level? What type of pain will he indure from the surgery? Will he require assistance with bowel movements, urinating? How long is the recovery period as an adult? Please help before January 14, 2004.

[Kevin Pho, MD]

Failure of normal posterior anchoring of the gubernaculum, epididymis and testis is called a bell clapper deformity because it leaves the testis free to swing and rotate within the tunica vaginalis of the scrotum much like the gong (clapper) inside of a bell.

The bell-clapper deformity was present in 12 percent among asymptomatic men.

It is possible that he was born in it.  As stated above, it is present in 12 percent of asymtommatic men.  I do not have numbers that demonstrate the heredity of the deformity.

Fertility is usually good after an orchiopexy.  10% of people may have fertility problems post-op.  

It is possible that a car accident or other scrotal trauma may have exacerbated the condition.

Regarding the surgery, it may be done on an outpatient basis. Bedrest is recommended for the first 2 to 3 days. Strenuous activity, including bicycling, should be avoided for at least 1 month to allow rehabilitation of the testis in its new position.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.