Workman S J, Kogan B A
Department of Urology, University of California School of Medicine, San Francisco 94143-0738.
Semin Urol. 1988 May;6(2):146-57.
Torsion of the spermatic cord is a common condition that requires emergent treatment. Diagnosis based on history and physical examination is rarely conclusive and, although a number of radiographic studies can be helpful, any clinically suspicious lesion should be treated immediately. Manual detorsion may be helpful, but operative exploration with bilateral orchiopexy is still essential. Prolonged torsion usually results in unilateral testicular atrophy and, in postpubertal animals, an autoimmune injury with consequent contralateral testicular damage is seen. This suggests that, in humans, necrotic and perhaps marginal testes should be removed. In addition, subfertility after unilateral torsion may be due to a preexisting abnormality in both testes. Nonetheless, the cornerstone of management remains rapid detorsion and bilateral fixation to prevent future torsion.
精索扭转是一种需要紧急治疗的常见病症。基于病史和体格检查的诊断很少能得出定论，尽管一些影像学检查可能有所帮助，但任何临床上可疑的病变都应立即治疗。手法复位可能有用，但双侧睾丸固定术的手术探查仍然至关重要。长时间扭转通常会导致单侧睾丸萎缩，在青春期后的动物中，会出现自身免疫性损伤，继而导致对侧睾丸受损。这表明，在人类中，坏死的以及可能处于边缘状态的睾丸应该切除。此外，单侧扭转后的生育力低下可能是由于双侧睾丸预先存在异常。尽管如此，治疗的基石仍然是快速复位和双侧固定，以防止未来发生扭转。
