Ameli Mojtaba, Parsapour Arezou, Gholami-Mahtaj Leila
Department of Urology, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran.
Faculty of Medicine, Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran.
Qatar Med J. 2016 Dec 24;2016(2):10. doi: 10.5339/qmj.2016.10. eCollection 2016.
Testicular torsion is a rare disease that mostly involves children. Peak incidence is in infancy and in adolescence. Testicular torsion is rarely seen in men over 40 years of age and has only once been accompanied with spermatocele. We report the case of a 40-year-old man with testicular pain one day prior to visiting our clinic. The patient's visit to the clinic was delayed due to history of occasional testicular pain related to his bilateral spermatoceles. On arrival, a color Doppler ultrasound test was performed, which revealed heterogeneous echo in the right testis with no vascular flow, suggestive of torsion, as well as two cystic lesions in the right and left scrotums indicating spermatoceles. The patient was immediately transferred to the operating room where the bilateral spermatoceles were resected and after detorting, the right testis was saved. After four months, a normal left testis along with partial right testicular atrophy was observed. It is highly recommended to educate patients with spermatocele who have no indication for surgical treatment to visit their physician in case any new testicular pain is experienced. Furthermore, testicular pain regardless of the co-existing pathology may always be treated as an indicator of suspected torsion.
睾丸扭转是一种罕见疾病，主要累及儿童。发病高峰在婴儿期和青春期。40岁以上男性很少见睾丸扭转，且仅有一次伴有精液囊肿。我们报告一例40岁男性患者，在前来我院就诊前一天出现睾丸疼痛。由于既往有双侧精液囊肿偶尔引起睾丸疼痛的病史，该患者前来就诊的时间有所延迟。到达后，进行了彩色多普勒超声检查，结果显示右侧睾丸回声不均匀且无血流信号，提示扭转，同时右侧和左侧阴囊内有两个囊性病变，提示精液囊肿。患者立即被转至手术室，切除了双侧精液囊肿，扭转复位后，右侧睾丸得以挽救。四个月后，观察到左侧睾丸正常，右侧睾丸部分萎缩。强烈建议对无手术治疗指征的精液囊肿患者进行教育，使其在出现任何新的睾丸疼痛时及时就医。此外，无论并存何种病理情况，睾丸疼痛均应始终被视为疑似扭转的指标。
