González Ruiz Y, Izquierdo Hernández B, Bragagnini Rodríguez P, Siles Hinojosa A, Fernández Atuán R, Álvarez García N, Gracia Romero J
Servicio de Cirugía Pediátrica. Hospital Universitario Miguel Servet. Zaragoza.
Cir Pediatr. 2016 Oct 10;29(4):171-174.
To assess the long-term evolution of the testicles preserved after testicular torsion (TT).
We realized a prospective study by ultrasound of patients diagnosed TT that underwent orchidopexy. We reviewed 85 patients treated for acute scrotum (2004-2014), finding 49TT. We excluded from the study 15 perinatal torsions, 14 orchiectomies and 5 patients who refused to participate. We analyzed 15 patients, comparing testicular volumes between affected and contralateral testes, and the difference in volume between the two testes of the 15 cases with 14 control patients (Mann-Whitney U test).
15 patients underwent surgery at a mean age of 10,7 years, with an average time of 6 hours evolution [0,7-24]. The control ultrasound was performed at a mean age of 14,7 years, after a mean time of 47 months after the episode, finding a medium volume of the affected and contralateral testicle of 9,3 cc and 12,6 cc, respectively (p = 0,683). The median of the difference between the volumes was 0'8 cc [0,1-12,80]. In the control group, ultrasounds were performed at a mean age of 16 years, with an average volume of 6,64 cc on right testicle and 6,26 cc on the left, and median volume difference of 0,34 cc [0,05-4,59]; with no statistically significant difference (p = 0,270) between testicular volume differences of cases and controls.
Testicular orchidopexy in patients with TT with less than 6 hours of evolution does not affect the long-term testicular growth, compared with the contralateral testis growth and testes of the normal population.
评估睾丸扭转(TT)后保留睾丸的长期演变情况。
我们对诊断为TT并接受睾丸固定术的患者进行了超声前瞻性研究。我们回顾了2004年至2014年期间因急性阴囊接受治疗的85例患者,发现49例TT。我们将15例围产期扭转、14例睾丸切除术患者以及5例拒绝参与的患者排除在研究之外。我们分析了15例患者,比较患侧睾丸与对侧睾丸的体积,以及这15例患者的双侧睾丸体积差异与14例对照患者的差异(曼-惠特尼U检验)。
15例患者接受手术时的平均年龄为10.7岁,平均病程为6小时[0.7 - 24小时]。对照超声检查在平均年龄14.7岁时进行,发作后平均时间为47个月,发现患侧和对侧睾丸的平均体积分别为9.3立方厘米和12.6立方厘米(p = 0.683)。体积差异的中位数为0.8立方厘米[0.1 - 12.80立方厘米]。在对照组中,超声检查在平均年龄16岁时进行,右侧睾丸平均体积为6.64立方厘米,左侧为6.26立方厘米,体积差异中位数为0.34立方厘米[0.05 - 4.59立方厘米];病例组与对照组的睾丸体积差异无统计学显著差异(p = 0.270)。
与对侧睾丸生长及正常人群的睾丸相比,病程少于6小时的TT患者进行睾丸固定术不影响睾丸的长期生长。