Hospital de Base do Distrito Federal, Brasília, DF, Brazil.
Hospital de Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
Einstein (Sao Paulo). 2022 Apr 20;20:eAO6605. doi: 10.31744/einstein_journal/2022AO6605. eCollection 2022.
To assess testicular volumes and sexual maturation in patients with testicular torsion.
A retrospective analysis of consecutively treated patients with testicular torsion between 2016 and 2018. Age, pubic hair staging (Tanner), and by ultrasonography, volume of the unaffected testis (in cubic centimeters) were evaluated either immediately before surgery or at the first postoperative visit. Patients with previous testicular disease, such as cryptorchidism, or with no records of testicular volume were excluded. The analysis included descriptive statistics and Bayesian regression.
We treated 149 patients during the study period, and 141 (94.6%, median age 17.3 years) met the inclusion criteria. Median testicular volume was 13.0cm3 (interquartile range of 10.5-15.2), with similar right and left volumes (12.9cm3versus 13.3cm3; p=0.94). Sixty-five (46.1%) patients were Tanner stage IV, 17 (12.1%) stage III, and 59 (41.8%) stage V.
In this study, we were able to estimate volumes of testicular torsion, which aggregated around late puberty values (13.0cm3 for the whole dataset, 12.2cm3 for patients <25 years), suggesting that testicular hypermobility, due to congenital anatomical abnormalities, remains quiescent until the organ reaches a critical volume, after which torsion becomes possible. These findings provide a tentative explanation for the disease's age distribution.
评估睾丸扭转患者的睾丸体积和性成熟度。
对 2016 年至 2018 年连续治疗的睾丸扭转患者进行回顾性分析。评估年龄、阴毛分期（Tanner）和超声检查，评估未受累睾丸的体积（以立方厘米计），或在手术前或第一次术后就诊时进行。排除既往有隐睾等睾丸疾病或无睾丸体积记录的患者。分析包括描述性统计和贝叶斯回归。
研究期间共治疗了 149 例患者，符合纳入标准的有 141 例（94.6%，中位年龄 17.3 岁）。睾丸体积中位数为 13.0cm3（四分位间距为 10.5-15.2），左右侧体积相似（12.9cm3 对 13.3cm3；p=0.94）。65 例（46.1%）患者为 Tanner 分期 IV 期，17 例（12.1%）为 III 期，59 例（41.8%）为 V 期。
在这项研究中，我们能够估计睾丸扭转的体积，其聚集在青春期后期（整个数据集为 13.0cm3，<25 岁患者为 12.2cm3），这表明由于先天性解剖异常，睾丸活动性在达到临界体积之前仍保持静止，之后扭转才有可能发生。这些发现为该疾病的年龄分布提供了一个初步解释。
