Bilateral Orchidopexy in a Hypochondriacal(Somatic Symptom Disorder) Patient and Determination ofFitness for Bilateral Orchidectomy

DSM-5 identifies two disorders: somatic symptom disorder and illness anxiety disorder, to replace hypochondriasisin DSM-IV. Patients with both disorders are intensely anxious about the possibility of an undiagnosed illness or devote excessivetime and energy to health concerns and are not easily reassured. Both disorders cause considerable distress and life disruption,even at moderate levels. However, hypochondriasis (DSM-IV) is an indication for neither orchidopexy nor orchidectomy. This isthe rationale for this report which is the first of its kind to the best of available literature. This is an original case report of interestto a particular clinical specialty of mental health but it will have a broader clinical impact across medicine.Case Presentation.A30-year-old black male presented to a primary care clinic with multiple internet searches on the topic of testicular pain and itsdifferential diagnosis. He had a bilateral orchidopexy for a suspected torsion. He was referred to mental health unit, to determinefitness for further surgery.Conclusions. If hypochondriasis is suspected in a medical orsurgical inpatient, a psychological medicineconsultation should be performed, to elucidate the diagnosis, to avoid unnecessary procedures, and to optimize patient’s care