Emergency treatment of testicular torsion and postoperative follow-up: A 71 case report

Abstract

This study presented our experience in the treatment of testicular torsion, which may help achieve early diagnosis and improve therapeutic effects. A retrospective analysis was conducted in 71 patients with testicular torsion who were treated in our hospital from October 2007 to April 2011. The age of the patients ranged from 16 days to 34 years. All the patients had unilateral testicular torsion, which took place on the left side in 43 cases and on the right side in 28 cases. The course of the disease varied between three hours to 30 days. Post-operative follow-up was conducted until October 2011. Items examined included signs and symptoms at their first clinical visit, ultrasound findings, treatment in emergency surgery, and post-operative follow-up. In this study, the 71 patients were diagnosed with testicular torsion by color Doppler sonography, 7 had testicular fixation, 63 patients received orchiectomy, while 1 patient did not undergo surgery due to pressure from family members. Post-operative follow-up showed that the one patient’s testicle, which had been reserved, atrophied, while all the other survived. No recurrence was found during the follow-up visits. It is concluded that an early diagnosis and surgery is important in improving the survival rate of testicular torsion, and the diagnosis and treatment by the first attending clinician is of critical importance.

Keywords

testicular torsion / emergency treatment / post-operative follow-up

References

[1] ArdaI.S., OzyaylaliI.. Testicular tissue bleeding as an indicator of gonadal salvageability in testicular torsion surgery. BJU Int, 2001, 87(1): 89-92

[2] RingdahlE., TeagueL.. Testicular torsion. Am Fam Physician, 2006, 74(10): 1739-1743

[3] DograV.. Bell-clapper deformity. AJR Am J Roentgenol, 2003, 180(4): 1176

[4] ThakareN., O’flynnK.J., PearceI.. Testicular torsion: a urological emergency. Trends in Urology & Men’s Health, 2010, 1(1): 31-34

[5] LyronisI.D., PloumisN., VlahakisI., et al.. Acute scrotum-etiology, clinical presentation and seasonal variation. Indian J Pediatr, 2009, 76(4): 407-410

[6] MolokwuC.N., SomaniB.K., GoodmanC.M.. Outcomes of scrotal exploration for acute scrotal pain suspicious of testicular torsion: a consecutive case series of 173 patients. BJU Int, 2011, 107(6): 990-993

[7] WaldertM., KlatteT., SchmidbauerJ., et al.. Color Doppler sonography reliably identifies testicular torsion in boys. Urology, 2010, 75(5): 1170-1174

[8] Wu JP. Wu Jieping Urology. Shandong Science and Technology Publishing House, 2006:1955–1958

[9] WuM.C., WuZ.D.. . Huang Jiasi Surgery, 20087th EditionBeijing, China, People’s Medical Publishing House, 2422

[10] JinX.L., ZhuX.M., ZhangT.L., et al.. Diagnosis and treatment of testicular torsion and spermatic cord torsion (Report of 68 cases). J Clin Urol, 2006, 21(5): 367-371

[11] SoccorsoG., NinanG.K., RajimwaleA., et al.. Acute scrotum: is scrotal exploration the best management?. Eur J Pediatr Surg, 2010, 20(5): 3l2-3l5

[12] FuG.B., QianL.X., CuiY.G., et al.. Antisperm-antibodies induced by testicular torsion and its influence on testicular function. Zhonghua Nan Ke Xue (Chinese), 2006, 12(11): 988-991