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儿童与青少年睾丸扭转的临床结局及患者特征差异

Differences in Clinical Outcomes and Patients' Characteristics Between Childhood and Adolescent Testicular Torsion.

作者信息

Hosokawa Takahiro

机构信息

Radiology, Saitama Children's Medical Center, Saitama, JPN.

出版信息

Cureus. 2024 Dec 6;16(12):e75245. doi: 10.7759/cureus.75245. eCollection 2024 Dec.

Abstract

OBJECTIVES

Testicular torsion, a condition requiring urgent intervention, can occur at any age and present with diverse symptoms. To the best of our knowledge, no study has evaluated the characteristics of testicular torsion in childhood, a less common age group. This study showed differences in patients' characteristics between childhood and adolescence and the variation across ages.

METHODS

The 58 patients included were classified into two groups: childhood (1-9 years) and adolescence (10-16 years). The following patient characteristics were compared between the two groups using Fisher's exact and Mann-Whitney U tests: presence or absence of acute scrotum as the first symptom, period from symptom onset to diagnosis, and whether testicular salvage was achieved. Single linear regression analysis was used for testicular salvage and acute scrotum as first symptom rates to evaluate the relationship between these factors and each age every one year.

RESULTS

Testicular torsion was observed in childhood and adolescence in 11 and 47 of the patients, respectively. The average period from first symptom onset to diagnosis was 19.97±24.31 (range, 2-72) hours, with acute scrotum as the first symptom observed in 43 patients and testicular salvage in 39. Significant differences were observed between the childhood and adolescence groups regarding the period from first symptom onset to diagnosis, presence/absence of acute scrotum as the first symptom, and testicular salvage/not salvage. Additionally, strong correlations between patient age and both testicular salvage and acute scrotum as first symptom rates were observed.

CONCLUSIONS

Testicular torsion in childhood tends to present without typical symptoms as the acute scrotum, leading to delayed diagnosis and lower testicular salvage rates of the affected testis.

摘要

目的

睾丸扭转是一种需要紧急干预的疾病,可发生于任何年龄,症状多样。据我们所知,尚无研究评估儿童期(这一较不常见的年龄组)睾丸扭转的特征。本研究显示了儿童期和青春期患者特征的差异以及各年龄段的变化。

方法

纳入的58例患者分为两组:儿童期(1 - 9岁)和青春期(10 - 16岁)。使用Fisher精确检验和Mann-Whitney U检验比较两组患者的以下特征:是否以急性阴囊作为首发症状、从症状出现到诊断的时间以及是否实现睾丸挽救。采用单线性回归分析评估睾丸挽救率和急性阴囊作为首发症状的发生率与每个年龄每年之间的关系。

结果

分别在11例儿童期患者和47例青春期患者中观察到睾丸扭转。从首发症状出现到诊断的平均时间为19.97±24.31(范围,2 - 72)小时,43例患者以急性阴囊作为首发症状,39例实现睾丸挽救。在从首发症状出现到诊断的时间、是否以急性阴囊作为首发症状以及睾丸是否挽救方面,儿童期和青春期组之间存在显著差异。此外,观察到患者年龄与睾丸挽救率和急性阴囊作为首发症状的发生率之间存在强相关性。

结论

儿童期睾丸扭转往往不表现为典型的急性阴囊症状,导致诊断延迟,患侧睾丸的挽救率较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ea6/11700902/b289db0b3211/cureus-0016-00000075245-i01.jpg

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