Cummings James M, Boullier John A, Sekhon Davinder, Bose Kelley
Division of Urology, University of South Alabama College of Medicine, Mobile, Alabama, USA.
J Urol. 2002 May;167(5):2109-10.
Testicular torsion in adulthood is thought to be relatively unusual. We compared a series of men 21 years old or older with testicular torsion with a concurrent series of younger patients with torsion.
We reviewed the medical records of patients admitted with testicular torsion in a 9-year period to hospitals affiliated with our institution. Data included patient demographics, history, physical findings, radiographic results if any, operative findings and outcome (testicular salvage versus loss).
The charts of 48 patients were evaluated. Excluded from study was a neonate with torsion and 3 males who underwent delayed surgery for presumed missed torsion. Of the remaining 44 patients we compared 17 who were 21 years old or older (range 21 to 34) with 27 younger than 21 (range 8 to 20). The salvage rate differed in the 2 age groups with 70.3% of testes salvaged in the younger group versus only 41% in the older group. A factor affecting salvage in each group was time to presentation. In the older age group patients in whom the testis was lost had a significantly higher mean delay in presentation than those in whom it was salvaged (102 versus 11 hours). A similar pattern was noted in the younger group with a mean time to presentation of 108 and 6.5 hours in those with testicular loss and salvage, respectively. Mean time between presentation and operation was 7.1 hours in the older and 4.8 in the younger group, which was not statistically different. A significant difference was noted in the degree of spermatic cord twisting. The cord was twisted a mean of 585 degrees in the adults versus 431 in the younger group.
Testicular torsion in adults was more common in our series than expected. Salvage of the affected testis was better in younger patients, presumably due to less twisting of the cord.
成年期睾丸扭转被认为相对不常见。我们将一系列21岁及以上睾丸扭转男性患者与同期的年轻睾丸扭转患者进行了比较。
我们回顾了9年间在我们机构附属医院因睾丸扭转入院患者的病历。数据包括患者人口统计学信息、病史、体格检查结果、影像学检查结果（如有）、手术所见及结果（睾丸挽救与否）。
对48例患者的病历进行了评估。一名扭转的新生儿及3例因推测漏诊扭转而接受延迟手术的男性被排除在研究之外。在其余44例患者中，我们将17例21岁及以上（年龄范围21至34岁）的患者与27例21岁以下（年龄范围8至20岁）的患者进行了比较。两个年龄组的挽救率不同，较年轻组70.3%的睾丸得以挽救，而较年长组仅为41%。影响每组挽救情况的一个因素是就诊时间。在较年长组中，睾丸丧失的患者就诊平均延迟时间显著高于睾丸得以挽救的患者（分别为102小时和11小时）。在较年轻组中也观察到类似模式，睾丸丧失和得以挽救的患者就诊平均时间分别为108小时和6.5小时。较年长组就诊与手术之间的平均时间为7.1小时，较年轻组为4.8小时，差异无统计学意义。精索扭转程度存在显著差异。成人组精索平均扭转585度，较年轻组为431度。
在我们的系列研究中，成人睾丸扭转比预期更常见。年轻患者中受影响睾丸的挽救情况更好，可能是由于精索扭转程度较轻。
