Ayvaz Olga Devrim, Cansaran Sabri, Celayir Ayşenur, Erol Zeynep Eylul
Department of Pediatric Surgery, University of Health Sciences Turkey, Istanbul Zeynep Kamil Maternity and Children's Diseases Health Training and Research Center, Dr. Fahri Atabey Cd., Üsküdar, 34668, Istanbul, Turkey.
Faculty of Medicine Kayışdağı, Yeditepe University, İnönü Mahallesi, Kayışdağı Cd., Ataşehir, 34755, Istanbul, Turkey.
Pediatr Surg Int. 2025 Jun 23;41(1):187. doi: 10.1007/s00383-025-06093-9.
Intrauterine testicular torsion is a rare pathology and there is no consensus on how to treat and follow-up these patients. This study aims to evaluate the surgical indications, findings, testicular viability rate, and management approaches of intrauterine testicular torsion cases in our center over a 12-year period.
17 patients diagnosed with intrauterine testicular torsion and operated on between January 2010 and 2023 were included in the study. The patients' age at birth, mode of birth, weight, maternal age, genetic diagnosis, presence of other anomalies, complaints upon presentation, physical examination findings, laboratory results, preoperative ultrasound and Doppler imaging findings, surgery date, surgery weight, torsion side, surgery method and findings, torsion type (intravaginal, extravaginal), degree of torsion, length of hospital stay, complications, pathology results, testicular status in postoperative follow-up and ultrasonography and Doppler findings were examined.
The median age of the cases was one day. Orchiectomy was performed in fourteen cases (82.4%), while three cases (17.6%) were managed with detorsion and orchiopexy. Prophylactic contralateral orchiopexy was performed in four (23.5%) cases, and undescended testicle surgery was performed in one (5.9%) case. None of the testes managed with detorsion and orchiopexy remained viable during follow-up.
The etiology, risk factors, and optimal management approach of intrauterine testicular torsion are not fully elucidated. Based on the current literature, the salvage rates are close to zero in our study as well as many others despite the efforts to promptly diagnose and operate intrauterine torsion cases. Creating management algorithms based on the data gathered from multiple centers over the years can yield better outcomes for this devastating pathology.
宫内睾丸扭转是一种罕见的病理情况，对于如何治疗和随访这些患者尚无共识。本研究旨在评估我院中心12年间宫内睾丸扭转病例的手术指征、发现、睾丸存活率及处理方法。
本研究纳入了2010年1月至2023年期间诊断为宫内睾丸扭转并接受手术的17例患者。检查了患者的出生年龄、出生方式、体重、母亲年龄、基因诊断、是否存在其他异常、就诊时的主诉、体格检查结果、实验室检查结果、术前超声和多普勒成像结果、手术日期、手术时体重、扭转侧、手术方法及发现、扭转类型（鞘内型、鞘外型）、扭转程度、住院时间、并发症、病理结果、术后随访中的睾丸状况以及超声和多普勒检查结果。
病例的中位年龄为1天。14例（82.4%）进行了睾丸切除术，3例（17.6%）采用扭转复位和睾丸固定术处理。4例（23.5%）进行了预防性对侧睾丸固定术，1例（5.9%）进行了隐睾手术。在随访期间，采用扭转复位和睾丸固定术处理的睾丸均未存活。
宫内睾丸扭转的病因、危险因素及最佳处理方法尚未完全阐明。根据目前的文献，尽管努力及时诊断和手术治疗宫内扭转病例，但在我们的研究以及其他许多研究中，挽救率都接近于零。基于多年来从多个中心收集的数据创建管理算法，对于这种毁灭性的病理情况可能会产生更好的结果。
