Lu Qun, Ji Changwei, Zhang Gutian, Lian Huibo, Zhang Shiwei, Li Xiaogong, Gan Weidong, Guo Hongqian
Department of Urology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.
Department of Urology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China; Email:
Zhonghua Wai Ke Za Zhi. 2015 Aug 1;53(8):599-602.
To improve the diagnosis and treatment of testicular torsion.
The clinical features of 49 testicular torsion patients admitted to Department of Urology Nanjing Drum Tower Hospital from April 2008 to March 2014 were retrospectively analyzed, the average age was (21 ± 6) years (range 13-52 years).Forty-four cases underwent the color Doppler flow imaging of scrotum, demonstrated reduction of the testicular blood supply in 9 cases and loss of the testicular blood supply in 35 cases. Orchiectomy or orchiopexy was performed according to the testicular blood supply, the contralateral testis fixation was performed in all patients. A two-tailed Student's t-test was used to compare the data between two groups, Pearson correlation analysis was used to analyze the correlation of diurnal temperature and number of cases.
All the patients with testicular torsion were Tunica-reversed, 38 (77.5%) cases occurred from November to April. The monthly incidence of testicular torsion was positively correlated with diurnal temperature (r = 0.6434, P = 0.024). Forty-four cases underwent the color Doppler flow imaging, demonstrated the reduction or loss of the testicular blood supply, and these patients were confirmed to be testicular torsion by surgical exploration. The salvage rates of testis in patients with testicular torsion were 2/2, 5/15, 2/9 and 4.2% (1/24) in those seeking medical attention within 6, 12, 24 hours and over 24 hours after the onset of pain. All the patients were followed up for 3 to 75 months, and no one experienced recurrent torsion.
The incidence of testicular torsion is higher during the spring and winter, diurnal temperature change is associated with testicular torsion. The diagnostic rate of color Doppler flow imaging is high, which can be chosen as the primary method. Prompt recognition and treatment are necessary for testicular salvage.
提高睾丸扭转的诊断与治疗水平。
回顾性分析2008年4月至2014年3月南京鼓楼医院泌尿外科收治的49例睾丸扭转患者的临床资料,平均年龄为(21±6)岁(范围13 - 52岁)。44例患者行阴囊彩色多普勒血流成像检查,其中9例显示睾丸血供减少,35例显示睾丸血供消失。根据睾丸血供情况行睾丸切除术或睾丸固定术,所有患者均行对侧睾丸固定术。采用两独立样本t检验比较两组数据,采用Pearson相关分析分析日温差与病例数的相关性。
所有睾丸扭转患者均为鞘膜反转型,38例(77.5%)发生于11月至次年4月。睾丸扭转的月发病率与日温差呈正相关(r = 0.6434,P = 0.024)。44例行阴囊彩色多普勒血流成像检查,显示睾丸血供减少或消失,经手术探查确诊为睾丸扭转。睾丸扭转患者在疼痛发作后6小时、12小时、24小时及24小时以上就诊者,睾丸挽救率分别为2/2、5/15、2/9和4.2%(1/24)。所有患者随访3至75个月,无1例复发扭转。
睾丸扭转发病率在春冬季较高,日温差变化与睾丸扭转有关。彩色多普勒血流成像诊断率高,可作为首选方法。及时识别与治疗对挽救睾丸至关重要。