Sorensen Mathew D, Galansky Stanley H, Striegl Amanda M, Mevorach Robert, Koyle Martin A
Department of Urology, University of Colorado Health Sciences Center, Denver, Colorado 80218, USA.
Urology. 2003 Jul;62(1):132-4. doi: 10.1016/s0090-4295(03)00402-3.
To determine the effectiveness of immediate surgical exploration in salvaging perinatal testicular torsion.
A retrospective analysis from 1995 to 2000 of boys younger than 30 days of age with surgically documented extravaginal testicular torsion was conducted. All cases were diagnosed after a normal testicular examination by a neonatologist, and all patients underwent urgent exploration to confirm the exact diagnosis and attempt testicular salvage by detorsion with bilateral orchiopexy. If a nonviable testis was determined intraoperatively, it was removed and contralateral orchiopexy was performed. Success was determined by physical examination at 6 months of follow-up.
Ten patients with 10 affected testes were identified and a total of 4 (40%) were salvaged. All the studied testes were right-sided, and of the 4 salvaged testes, all were palpably normal and equal in size to their mate at the 6-month follow-up examination. Of the 6 removed testes, 1 was potentially viable by permanent pathologic section analysis despite preoperative ultrasonography demonstrating no flow and a negative intraoperative bleed test.
Boys younger than 30 days old presenting with clinical findings suggestive of extravaginal testicular torsion who are expeditiously explored surgically may have a salvageable event in at least 40% to 50%. These statistics are similar to the salvage rates found with the similar management approach of intravaginal torsion.
确定即刻手术探查在挽救围产期睾丸扭转中的有效性。
对1995年至2000年间年龄小于30天、经手术证实为睾丸外扭转的男孩进行回顾性分析。所有病例均由新生儿科医生在睾丸检查正常后确诊，所有患者均接受紧急探查以明确确切诊断，并通过双侧睾丸固定术扭转复位尝试挽救睾丸。如果术中确定睾丸无活力，则将其切除并进行对侧睾丸固定术。通过随访6个月时的体格检查确定是否成功。
确定了10例患侧睾丸的10名患者，共挽救了4例（40%）。所有研究的睾丸均为右侧，在6个月的随访检查中，4例挽救的睾丸触诊均正常，且大小与其对侧睾丸相等。在6例切除的睾丸中，尽管术前超声显示无血流且术中出血试验为阴性，但经永久病理切片分析，1例睾丸可能有活力。
年龄小于30天、临床表现提示睾丸外扭转且接受快速手术探查的男孩，至少有40%至50%的几率可成功挽救睾丸。这些统计数据与采用类似处理方法治疗睾丸内扭转的挽救率相似。
