Department of Pediatric and Adolescent Surgery, Medical University of Graz, Austria.
Acta Paediatr. 2012 Jul;101(7):e282-6. doi: 10.1111/j.1651-2227.2012.02644.x. Epub 2012 Mar 24.
This study reviewed the demographic, epidemiological and clinical factors of boys seen at a single centre who underwent surgical exploration for testicular torsion.
Retrospective single-centre review of boys with testicular torsion between 1996 and 2011 was made.
Testicular torsion (right n = 43, left n = 60, bilateral n = 1) was identified in 104 boys between 0 and 18 years. Ten newborns presented with 11 intrauterine torsions. Nine torsions presented in undescended inguinal testes (one intrauterine). In 94 boys with descended testes, presentation included pain (76%), scrotal swelling (65%) and abdominal symptoms (22%). Ultrasonography was performed in 85 patients with false-negative results in 4 (4.7%). Orchiectomy was performed during initial exploration in 41, with significantly higher rates of orchiectomies in patients with late (>6 h) versus patients with early referrals (<6 h) (56% vs. 9.1%). Histological evaluation was carried out in 68 testes, with 43 resected testes demonstrating haemorrhagic necrosis. In 25 biopsied testes, histology revealed acute parenchymal bleeding (n = 14), onset of parenchymal infarction (n = 8), orchitis (n = 1) and normal tissue (n = 2). Eighty-two patients were followed up with pathological findings in four patients: testicular atrophies requiring orchiectomy (n = 2), testicular autolysis (n = 1) and small testicular vein thrombosis (n = 1).
Chances of testicular salvage after torsion are higher if patients present early. The majority of patients presenting late (>6 h) require orchiectomy owing to testicular necrosis.
本研究回顾了在一家中心接受手术探查的睾丸扭转男孩的人口统计学、流行病学和临床因素。
对 1996 年至 2011 年间在一家中心接受手术探查的睾丸扭转男孩进行回顾性单中心回顾。
在 0 至 18 岁的 104 名男孩中发现睾丸扭转（右侧 43 例，左侧 60 例，双侧 1 例）。10 名新生儿出现 11 例宫内扭转。9 例扭转发生在未降入腹股沟的睾丸（1 例宫内）。在 94 名降入睾丸的男孩中，表现包括疼痛（76%）、阴囊肿胀（65%）和腹部症状（22%）。85 例患者进行了超声检查，4 例（4.7%）结果为假阴性。在 41 例行初次探查的患者中进行了睾丸切除术，与早期（<6 小时）就诊的患者相比，晚期（>6 小时）就诊的患者睾丸切除术率显著较高（56%对 9.1%）。对 68 个睾丸进行了组织学评估，其中 43 个切除的睾丸显示出血性坏死。在 25 个活检睾丸中，组织学显示急性实质内出血（n = 14）、实质梗死开始（n = 8）、睾丸炎（n = 1）和正常组织（n = 2）。82 例患者得到随访，4 例患者发现病理结果：需要睾丸切除术的睾丸萎缩（n = 2）、睾丸自溶（n = 1）和小睾丸静脉血栓形成（n = 1）。
如果患者早期就诊，扭转后保留睾丸的机会更高。大多数晚期（>6 小时）就诊的患者因睾丸坏死需要睾丸切除术。
