There is a paucity of literature on testicular complications after kidney transplant. Testicular necrosis after kidney transplantation has only been reported twice before. We present a 60- year-old man with end-stage renal disease who underwent uneventful deceased-donor kidney transplant. The patient's postoperative course was complicated by delayed graft function, urinary tract infection, epididymo-orchitis, and a necrotic testis necessitating radical orchiectomy on postoperative day 15. With their complex comorbidities compounded by a high burden of genitourinary complications, kidney transplant recipients may face testicular complications post-transplant due to the inherent risk posed by intraoperative manipulation of spermatic cord and ligation of lymphovascular structures.
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